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Posts for: January, 2018

By The Brace Place Orthodontics
January 30, 2018
Category: Oral Health
Tags: geographic tongue  
ThoseRedPatchesonYourTongueareNothingtobeAlarmedAbout

If you've ever been alarmed to find oddly-shaped red patches on your tongue, you can relax for the most part. Most likely, you're part of a small fraction of the population with a condition known as geographic tongue.

The name comes from the irregular shape of the patches that seem to resemble land formations on a map. Its medical name is benign migratory glossitis, which actually describes a lot about the condition. The patches are actually areas of inflammation on the tongue (“glossus” – tongue; “itis” – swelling) that appear to move around or migrate. They're actually made up of areas where the tiny bumps (papillae) you normally feel have disappeared: the patches feel flat and smooth compared to the rest of the tongue.

We're not sure why geographic tongue occurs. It often runs in families and seems to occur mostly in middle-aged adults, particularly women and non-smokers. It's believed to have a number of triggers like emotional stress, hormonal disturbances or vitamin or mineral deficiencies. There may also be a link between it and the skin condition psoriasis. Under a microscope the red patchiness of both appears to be very similar in pattern; the two conditions often appear together.

The bad news is we can't cure geographic tongue. But the good news is the condition is benign, meaning it's not cancerous; it's also not contagious. It poses no real health threat, although outbreaks can be uncomfortable causing your tongue to feel a little sensitive to the touch with a burning or stinging sensation. Some people may also experience numbness.

Although we can't make geographic tongue go away permanently, you should come by for an examination to confirm that is the correct diagnosis. Once we know for sure that you do have migratory glossitis, we can effectively manage discomfort when it flares up. You should limit your intake of foods with high acidity like tomatoes or citrus fruits, as well as astringents like alcohol or certain mouthrinses. We can also prescribe anesthetic mouthrinses, antihistamines or steroid ointments if the discomfort becomes more bothersome.

It may look strange, but geographic tongue is harmless. With the right care it can be nothing more than a minor annoyance.

If you would like more information on benign migratory glossitis, 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 “Geographic Tongue.”


By The Brace Place Orthodontics
January 22, 2018
Category: Dental Procedures
Tags: braces   orthodontics  

Braces can help you achieve the beautiful, straight smile you have always wanted. Teeth that are crooked, gapped, or misaligned can be bracescorrected with braces. There are several different types of braces, from traditional metal braces to modern clear aligner trays. Your orthodontist can help you select the right type of braces to suit your needs. At The Brace Place Orthodontics, Dr. Josh Goldknopf is your Jacksonville Beach orthodontist for braces.

Types of Braces

There are several different types of braces available today. Three of the more common types of braces are traditional metal braces, clear ceramic braces, and Invisalign clear aligners. Your Jacksonville Beach orthodontist can help you choose the type that is right for you based on your needs. 

Metal braces and clear ceramic braces are similar, as each relies on brackets and wires to move the teeth into the desired position. A primary difference is the brackets and wires associated with metal braces are silver in color, while ceramic braces utilized clear brackets and wires. Consequently, metal braces are readily noticeable to others while ceramic braces are much less conspicuous. An advantage of metal braces is that they tend to be stronger.

An alternative to both metal and ceramic braces is Invisalign. Rather than rely on brackets and wires to move the teeth, Invisalign uses clear, plastic aligner trays. Invisalign trays come with several benefits. Since they are clear, they are practically invisible to others. They are also soft and comfortable to wear with no hard brackets or wires to poke or irritate the mouth. Finally, Invisalign’s soft aligner trays are removable, which makes brushing and flossing less challenging than with metal or ceramic braces.

Caring for Your Smile with Braces

Caring for your smile with metal or ceramic braces can be challenging. It is not always easy to clean around the brackets, wires, and other hardware. It is also important to protect the brackets and wires from being damaged so they can continue straightening your teeth. To better protect your smile and your braces, keep the following tips in mind:

  • Avoid sticky foods and treats, such as chewing gum.
  • Avoid biting into extremely hard foods, such as hard candies.
  • Eliminate such habits as biting fingernails or chewing the ends of pens or pencils.
  • Use a floss threader to floss between teeth.
  • Use a water pick to clean teeth more thoroughly.
  • Use an interdental toothbrush or proxabrush to clean around brackets, bands and wires.
  • Wear a mouthguard when participating in sports or rigorous activities.

There are several things to know about braces, including the different types available and how to care for your teeth when wearing braces. An orthodontist can help you select the right type for you and provide additional guidance on how to care for them. To schedule an appointment with Dr. Goldknopf, call The Brace Place Orthodontics in Jacksonville Beach, FL at (904) 222-8588.


By The Brace Place Orthodontics
January 15, 2018
Category: Oral Health
WhatYoucandotoEasethatBurningSensationinYourMouth

Have you ever felt a hot, burning sensation in your mouth—like it had been scalded—but you didn't eat or drink anything that could have caused it?

While you may think you’re hallucinating, there’s another possibility: Burning Mouth Syndrome (BMS). This condition, which can last for years, produces sensations in the mouth of not only scalding or burning, but also tingling, numbness and a decline in your ability to taste. Patients may feel it throughout their mouth or only in localized areas like the lips, tongue or inside the cheeks.

The exact cause of BMS is also something of a mystery. It’s been theoretically linked to diabetes, vitamin or mineral deficiencies and psychological problems. Because it’s most common among women of menopausal age hormonal changes have been proposed as a factor, although hormone replacement therapy often doesn’t produce any symptomatic relief for BMS.

To complicate matters, other conditions often share the condition’s effects, which need to be ruled out first to arrive at a BMS diagnosis. A feeling of scalding could be the result of mouth dryness, caused by medications or systemic conditions that inhibit saliva flow. Some denture wearers may display some of the symptoms of BMS due to an allergic reaction to denture materials; others may have a similar reaction to the foaming agent sodium lauryl sulfate found in some toothpaste that can irritate the skin inside the mouth.

If these other possibilities can be ruled out, then you may have BMS. While unfortunately there’s no cure for the condition, there are ways to lessen its impact. There’s even the possibility that it will resolve itself over time.

Until then, keep your mouth moist by drinking lots of water or using saliva-stimulating products, limiting alcohol, caffeinated drinks or spicy foods and refraining from smoking. If you’re taking medications that could cause dry mouth, speak with your physician about changing to an alternative. And try to reduce stress in your life through exercise, mindfulness practices or support groups.

While BMS isn’t considered harmful to your physical health it can make life less enjoyable. Careful symptom management may help improve your quality of life.

If you would like more information on Burning Mouth Syndrome, 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 “Burning Mouth Syndrome: A Painful Puzzle.”


By The Brace Place Orthodontics
January 12, 2018
Category: Dental Procedures
Tags: air abrasion  
AirAbrasionAnAlternativetotheTraditionalDentalDrill

Drilling teeth is an essential part of repairing and restoring the damage caused by tooth decay. For generations dentists have relied on the dental drill with its rotating burr to remove decayed and damaged tooth material.

But while the dental drill is effective it also has its disadvantages. In the process of removing decayed material it inadvertently removes healthy structure near the target material. It often requires anesthesia to deaden the work area. And its noise and vibration are often unsettling to patients.

There is a growing alternative, though: air abrasion, a technology that's been around since the mid-20th Century. But recent advances in controlling the dust created by using abrasion, as well as new tooth-colored bonding materials to replace tooth structure, have sparked new interest among dentists and patients alike.

Also known as particle abrasion, this drill alternative uses a pressurized stream of fine particles to remove decayed material. Using a hand wand a dentist can precisely aim the stream of particles (usually aluminum oxide) to the specific areas of decay or softened material that need to be removed. As a result, it removes only a fraction of healthy tooth structure compared to traditional drilling. Air abrasion has also proven effective for removing staining without harming enamel.

Air abrasion also eliminates the sound and vibration associated with dental drills, and may not always require local anesthesia. On the other hand, it does have some limitations. For one, it's not as effective with larger cavities or working around older fillings. The tooth or teeth to be worked on must be carefully isolated from the rest of the mouth to keep the patient from swallowing the abrasive particles. And without a high-volume suction pump and good isolation protocols, the particles can produce something of a “sandstorm” in the treatment room.

But as air abrasion continues to advance, we may see improvements in these limitations. In a future time, the traditional dental drill may go the way of the horse and buggy.

If you would like more information on air abrasion as an alternative to drilling, 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 “Air Abrasion Technology.”


By The Brace Place Orthodontics
January 12, 2018
Category: Dental Procedures
HowKathyBatesRetainsHerMovie-StarSmile

In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.

When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”

Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.

There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.

By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.

So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.