Joshua Grooms DDS

"It doesn't hurt"  -Why waiting for pain, will cause pain in your wallet Working in an urgent care dental setting, I can tell you that the number one reason people are in my chair is pain.  These patients, for the most part, have known for a while that something was not right, but "it didn't hurt until now".  Patients ask me all the time when to expect pain or why one tooth hurts when another doesn't.  The answer is that teeth play by no rules.  I have seen people with large cavities, broken teeth, infection and not one bit of pain, and others with small cavities that are super sensitive to cold.  What I will tell you is that is is far more common for me to encounter those with big problems and no pain than those with small problems and some pain.  This is why it is so important to have your teeth checked and treated before the pain starts.  For the most part, when you start having that kind of discomfort or toothache that motivates you...

As summer approaches many people will be setting out for their summer vacations.This is meant to be a time to kick back, relax and enjoy some time without the stresses of everyday life.  However, as many people find out every year, a toothache can quickly ruin a good time.  I just saw a patient this week, that was planning his honeymoon.  He came in with an infection but did not want treatment until after he returned from in vacation.  My advice - don't put off your dental work. The risk people run into is that teeth are very unpredictable.  They may not hurt for years and years,even when there is an active infection, and then out of no where BAM!!! Swelling, severe pain, agony.  We are taught in dental school that one choice every patient has is NO TREATMENT. In the dental field we see this everyday.  We make a diagnosis, advice the patient of their condition, and the patient goes home with antibiotics, never to return. Unfortunately, this rarely...

As much as we try to save teeth, there are some circumstances where there just isn't a better option than to remove the tooth to prevent/treat pain and infection. This can be a stressful experience for anyone.  First, patients have stress of losing a tooth and all the emotions that go with the loss.  Second, the patient has to actually get through the procedure which can cause a lot of pre-appoitment anxiety. Working at a dental urgent care, I have to perform many extractions.  If you find yourself in this position,  I hope to give you some insight to help you prepare for your appointment. My first word of advice is easy to say but not easy to do.....DON'T PANIC!!!  Yes you here horror stories of dentist standing on peoples chests but I have had both easy and hard extractions and I have never had to climb up on someone's chest yet.  What's most important is that you find a dentist who you feel comfortable with.  This is probably the most importa...

When it comes time to talk about dentures, a lot of emotions can come into play.  Some people will feel excitement to finally get rid of pain, tooth infections, broken and black teeth.  Others will feel like they have failed, are too young for dentures, embarrassed that their teeth have gotten in the condition they are now.  For many, it is a combination of many of these feelings but none the less they know something has to be done.  Let me start by saying that dentures aren't for everyone.  They aren't the only way to replace teeth.  However, they are the most affordable option to replace missing and failing teeth.  I always take time during a denture consultation to explain to the patient that these are not natural teeth.  They do not function like natural teeth, that do no feel like natural teeth.  They are in-fact a prosthesis.  Much like an artificial arm or leg, they are meant to serve as a replacement to help with...

When to expect a visit from the Tooth Fairy It is a milestone that will make most parents cry, as they realize their little one is growing up much faster than they want.  A child losing their first tooth is a fun and exciting experience for most little ones but the truth is most parents are caught by surprise when that first tooth gets loose.  Let me cover some basics that may help parents be prepared for whats to come.   First, when will it happen.  While every kid is different, we can give you an average age range of when those baby teeth will come out.  Below is a eruption charts are provided by the American Dental Association and cover both baby teeth eruption and shedding as well as permanent teeth eruption time averages.  Baby Teeth Chart Permanent Teeth Chart   As you can see there are 20 baby teeth that must be lost to make room for 32 permanent teeth (including wisdom teeth).  All of the adult molars will come in behin...

Tooth Sensitivity Being summer time you may want to enjoy an ice cream or sno cone, and while these things are not great for your teeth, I realize that most people want to enjoy a treat every now and then.  Some of you however, suffer from cold sensitivity and can’t truly enjoy these summer indulgences. Let's discuss some possibilities and options that may help relieve these symptoms so you can actually relax and enjoy a cold treat. Cold sensitivity is one of the most common complaints of my patients, even those without any major problems.  First and foremost you should visit a dentist to make sure there is no underlying nerve problems, cavities, or pathology that needs to be addressed.  If you get the all clear from your dentist but still experience cold sensitivity you may want to try some over-the-counter products. There are several sensitive toothpastes that are very effective at relieving what we call “root sensitivity”.  I will explain what that mean...

Teeth Whitening Ask most people what they want to change about their teeth and one of the most common answers is definitely the color.  Everyone wants whiter teeth but most people don’t know much about what options exist. Lets first get into what is the difference when you buy an over the counter product vs. a in-office treatment system.  First and foremost the active ingredients are almost always the same. If you look at the over the counter box the active ingredient is most likely either carbamide peroxide or hydrogen peroxide. These over the counter products contain a lower percentage (usually between 6% and 10%) of this active ingredient than what you can get with an professional strength whitening system (usually between 22%-40%)  What this means is that in-office whitening systems are faster but maybe not more effective. The biggest advantage is you don’t have to leave the gel on as long or for as many days to get the desired results. However, the higher c...

Teeth Cleanings Dental cleanings are typically a patients favorite appointment in a dental office. Beyond just making your teeth shine and feel squeaky clean, a prophylaxis (the technical term) is used to promote a healthy dentition and gum health.   Most people don't realize what happens when they miss a cleaning or two.  First an foremost tartar builds up!!!  Dental plaques are soft and easily removed at home with proper brushing and flossing techniques.  However, tartar is calcified and adheres to the teeth so well that no amount of brushing or flossing will do the job.  This is where your dentist or dental hygienist come into play.  There are specialized dental instruments that can remove these deposits.  This is not just important for helping removed stains caused by dental tartar, but also to remove the colonies of bacteria living on these hard deposits.  If these continue to grow, over time it can lead to gum disease such as...

Remote Area Medical (RAM Clinic) Last month I had the opportunity to provide free dental services through a traveling clinic here in Gray, TN.  I had volunteered with this organization before and was very impressed.  My experience is that RAM is one of the most organized and well ram clinics I have seen.  From the moment I arrived, they are very welcoming and appreciative to have volunteers.  They have a complete system from triaging patients, making great patient records, organizing the dispensing of dental materials/instruments, and sterilization.  RAM has become a well oiled machine and it makes volunteering for them easy and rewarding. As much as I can brag about what a great clinic Remote Area Medical runs, its not what brings out all the volunteers....it's the patients.  People come from hours away, camp over night, wait in long lines all because they are in need.  We all know that there is a need for patients in our community but ...

Dr. Grooms treats a wide variety of dental issues at his practice.  One of which, includes taking care of those patients who have been without teeth for many years and have dentures sometimes older than he is.  As dentures are worn throughout the years they stain, wear and sometimes break.  As the teeth wear down, the bite will collapse causing an aging smile, sunken in face, and sometimes even pain in the jaw joints.  If you believe any of these apply to your situation, you should consider replacing your old worn denture.  Below is a picture of a denture, Dr. Joshua Grooms did this week.  The old denture was 30+ years old and the patient was more than ready for a new set.

Dr. Joshua Grooms would like to take some time this week to discuss toothbrushes.  His patients are always asking "Which toothbrush do you recommend?".  Every dentist may have a different opinion on exactly which brush you should be using.  Dr. Grooms, more importantly than telling you a certain name brand to go buy, wants to let you know what things to look for when picking out your next brush. 1.  SOFT BRISTLES - soft or even extra-soft bristles are so important.  Some patients go for the medium or even hard bristles thinking it will help remove the plaque and grime from their teeth better.  The truth is that plaque is relatively easy to remove with a soft bristle brush if the proper technique and time is taken to do so.  Hard bristles increase the risk of gum recession or even wearing down the enamel over time (toothbrush abrasion). Toothbrush Abrasion 2.  DON'T BRUSH TOO AGGRESSIVELY - if you are a "scrubber" or have signs of br...

So this week Dr. Grooms discussed crown restorations.  He wanted to share these images with you of an actual case he performed this week. The tooth started out with a large silver filling and broken tooth structure. The tooth was then reduced in all dimensions to support an all ceramic crown restoration Finally using Cerec technology a porcelain crown was milled in office and cemented same day!!!

My dentist says I need a Crown....What does that mean??????? Everyday in my practice I have to make the decision whether or not it is time for a tooth to receive a crown instead of just a large filling.  I have, on more than one occasion, ran into hesitant patients, who don't want to invest in a crown.  Let me explain what exactly what a crown is and answer some common questions. 1.  Can I just have a cap instead?  - You may hear the word "cap" used by your friends/family or even by your dentist.  What is the difference?  Absolutely nothing.  "Cap" is used to try to describe what a crown is.  When we place a crown on a tooth, it completely covers the coronal portion (top part) of the tooth, therefore we say think of it like a baseball cap covering your head. 2.  Why can't I just put a large filling in, it's much cheaper? -Fillings are a great way to restore a tooth when the amount of tooth structure lost is small.  After a large...

ROOT CANAL THERAPY I know the last thing people want to hear when the come to the dentist is that they need a root canal.  I believe part of this is because of a huge negative connotation that has been created in our society with root canals and pain.  Another part is that most people have no clue what is happening during a root canal procedure.  Let me help calm you fears and let you know what it is we are doing to help relieve or prevent future pain.   1.  When do I need a root canal? - Root canals are needed when the pulp (the nerve and blood vessels) in the tooth are inflamed and dying or dead and necrotic.   During the inflammation stage pain to cold and sometimes hot is very common.  This is typically what gets patients in the door.  The pain can be sever and linger after every drink, food item, or breath of cold air hits the tooth.  If you are having this symptom you should be seen right away for further evaluation. ...

Joshua Grooms, DDS, treats patients as an associate of ABC Family Dentistry in Greeneville, Tennessee. A skilled dental professional, Joshua Grooms, DDS , provides comprehensive care using the latest innovations in dentistry, including CEREC. Standing for Chairside Economical Restoration of Esthetic Ceramics, CEREC is a dental technology that employs computer-aided design (CAD) and computer-aided manufacturing (CAM) to provide dental restorations, including inlays, onlays, and crowns, in one appointment. Before creating a restorative tooth, the dentist uses the handheld CEREC Omnicam or Bluecam to acquire an image of the area to be restored. The image is then sent through advanced computer software that analyzes the image to calculate exact specifications for the restorative tooth. Once the specifications have been calculated, CEREC creates a digital model of the prepared tooth, which the dentist uses to create a restoration while the patient waits chairside. CEREC’s CAM programming...

As a member of ABC Family Dentistry in Greeneville, Tennessee, Joshua Grooms, DDS, helps patients to achieve long-term oral health through diagnostic, preventative, and treatment care. Joshua Grooms, DDS, and his colleagues use digital X-rays, which support the diagnostic process with increasingly accurate imaging. Dental X-rays function as a key element of a complete dental care experience. They allow a dentist to visualize the spaces inside and between teeth, as well as the bony ridges and root systems that support the teeth themselves. Dentists use these images to check for decay in areas that are not perceptible to the naked eye, while also assessing for any abscesses or masses that might compromise the stability of the teeth. When used as part of the diagnostic process, dental X-rays provide practitioners with a baseline from which to assess a patient's oral health. They can support the visualization of decay or impacted teeth before they present a problem, thus indicating...

As a practitioner with ABC Family Dentistry in Greenville, Tennessee, Joshua Grooms, DDS, helps patients care for both natural and replacement teeth. Joshua Grooms, DDS, draws on extensive experience treating patients with dentures, having built early-career experience as an associate with prominent dental offices such as Aspen Dental. Although dentures are artificial teeth and thus immune to decay, broken or dirty dentures can negatively impact the overall health of the mouth. Dentures that do not receive regular cleaning collect bacteria and tartar, which can then spread to the underlying tissues and cause irritation or infection. The same may occur in patients who have dentures and neglect to rinse and massage the gums or in those with partial dentures who do not brush and floss their remaining natural teeth. Denture wearers need to be similarly aware of any changes in the way their appliances fit. The structure of bones and gums can subtly shift with time, whether due to natura...

Joshua Grooms, DDS, practices as a member of ABC Family Dentistry, PLLC , in Greeneville, Tennessee. As part of his practice, Joshua Grooms, DDS, regularly performs extractions and other treatment procedures. The first step of a tooth extraction involves the dentist anesthetizing the area. Many extractions require only a local numbing agent, though more complex procedures require general anesthesia. Once the medication has taken effect, the dentist will being cutting away any gum or bone tissue that covers the tooth. After the tooth is fully exposed, the dentist uses a tool known as a dental elevator to loosen the tooth from its place within the jaw bone, in much the same way a camper loosens a tent peg before pulling it from the ground. The elevator allows the dentist to push the tooth against the bone and thus compress the spongy bone tissue. When the dentist has created enough space to loosen the tooth, he or she uses extraction forceps to rock and twist the tooth. This ultimatel...

No Messy impressions/ No Temporary crown   With digital Omnicam and Cerec   CAD/CAM technologies were are now able to offer strong, aesthetic, functional same day crowns in many dental situations.   I’m sure you do not get excited about having see the dentist and having to survive a messy impression taken over and over causing you to gag.   With digital impression the process is much more comfortable for you as patient.   After the tooth is prepared we simply scan your teeth to take a digital impression.   This impression is extremely accurate and allows us to fabricate a crown with precise fit.   Having a Cerec milling machine in our office then allows us to make that crown same day, no temporary crown for 2-4 weeks.   When the appointment is over you leave with an aesthetic all porcelain crown.      The appoint does tend to be slightly longer but the pay off is in 2 weeks when you don’t have to come back, be re-...

Hello, My name is Dr. Josh Grooms and welcome to my Blog!  I hope to use this as a forum for dental education.  As a practitioner, serving a broad patient base, I get asked all types of questions related to dental health.  It is my goal to help you better understand your oral health, as well as provide insight into new technology and procedures available at my practice.  If you are in need of a dentist and live in the Greeneville, TN area, I would love to have you as my patient.  Please visit our practice website at  http://abcfamilydentistrygreeneville.com/ or call the office at 423-639-2176 to set up an appointment. Sincerely, Joshua Grooms, DDS