Given the fact that baby-boomers are now reaching the age of retirement, understanding senior healthcare is becoming a top priority to many people. Discover your level of expertise in the area of oral health by taking the following true/false test.

True or False Self Assessment

1. All people eventually lose their teeth as they age.
2. Yellow teeth are a sign of gum disease.
3. If you have dentures, you no longer need regular dental check-ups.
4. Periodontal (gum) disease is a big problem that affects 3 out of 4 adults.
5. Electric toothbrushes can be a great option for seniors with arthritis or other debilitating conditions.

Answers

1. False: Your teeth are meant to last your lifetime.
2. False: Yellow teeth typically denote stained teeth from diet, medication, smoking, or growing older. And while they may not appear attractive, older, yellow teeth can in fact be healthy and free of gum disease. However, if your yellow teeth bother you, ask us if teeth whitening could be right for freshening up your smile while making you appear younger.
3. False: For those individuals who wear complete upper and lower dentures, you will always need routine dental exams, typically once a year so that you can be screened for cancer, as well as other oral conditions (i.e. candadiasis), to ensure the you obtain and maintain optimal oral health.
4. True: 75% of all adults over the age of 35 will experience some form of periodontal disease, a condition in which the gums become inflamed and infected. If left untreated, gum disease causes the bone that supports the teeth to deteriorate until the teeth are loosened and/or eventually lost (either they fall out on their own or must be removed). On a positive note, you can prevent gum disease by having good oral hygiene that includes flossing daily and brushing at least twice a day with a proper technique and fluoride toothpaste.
5. True: Under normal conditions, what matters most is not so much the type of toothbrush used (manual, electric or battery powered toothbrush), but rather how you use it. However, if you are unable to use a manual toothbrush effectively for proper brushing, then a power toothbrush may be able to facilitate proper cleaning more easily.

Want To Learn More?

If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.” Or, contact us today to discuss your questions or to schedule a consultation. ]]>Sun, 19 Jun 2011 04:14:22 -0500http://www.fennell-barondds.com/blog/post/the-top-ten-reasons-to-consider-porcelain-veneers.html

A veneer is a thin layer of dental ceramic tooth-colored restorative material, usually made of porcelain, which replaces some of the tooth's enamel and is physically bonded to it.

You might want to consider porcelain veneers:

10. If your teeth are severely discolored. (For best results we may recommend that your teeth be whitened before veneering them.)
9. If your teeth cannot be evenly whitened or matched by other means.
8. If your teeth are misshapen or worn, you can change their size or shape for optimum aesthetic appeal.
7. If you don't want to have your teeth prepared (drilled), prepless veneers may be an option to change your smile.
6. If you want as little natural tooth structure prepared as possible to improve your smile.
5. If you would like something temporary first to “test-drive” your new smile, then:
4. “Provisional veneers” allow you to try out your new smile and give us feedback before the final permanent veneers are placed.
3. If you want to improve your smile for just one tooth or even multiple teeth.
2. If you want long-lasting restorations — veneers can last from seven to twenty years or more.

And the top reason is:

1. Porcelain laminate veneers are among the most aesthetic ways to create a more beautiful, yet normal, looking smile.

Tell us what you want to change about your current smile, and we can tell you whether veneers are right for you. Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can learn more by reading about porcelain veneers in Dear Doctor magazine.

If you wake yourself by snoring or have been told by others that you snore, you should share this fact with us during your next visit. Why? Many people are shocked to learn that their dentist is a vital resource for treating snoring and Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (back of your throat) is blocked or obstructed causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more.

Self Test For Sleep Apnea

While your responses to the following questions are not a diagnosis for OSA, they can be warning signs that you may have OSA or another condition that is impacting your sleep.

1. Are you a loud habitual snorer?
2. Has anyone ever witnessed you holding your breath, gasping for air or even choking while asleep?
3. Do you regularly feel un-refreshed or tired even after waking from eight or more hours of sleep?
4. Do you find yourself easily falling asleep throughout your day at work or at home?
5. Do you suffer from poor concentration or judgment, memory loss, irritability and/or depression from lack of sleep?
6. Are you 15 pounds over the normal weight range for your height and/or does you neck measure more than 17 inches around if you are male and 16 inches if you are female?

If you answered, “yes” to any of the above questions, you should share your responses to all of these questions with both your physician and us so that you can receive a thorough examination to address your sleep concerns. And if you are diagnosed with OSA, we can help with specific oral treatment options that may work best for you.

Learn More

Learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.” Contact us today to discuss your questions or to schedule a consultation.

We pride ourselves on educating our patients regarding oral health and dental treatment. This is why we are providing you with these frequently asked questions (FAQs) regarding root canals. Our belief is that by being informed about this important dental treatment, you will be more comfortable should you ever require a root canal.

Exactly what is root canal treatment?

A root canal treatment is an endodontic procedure (“endo” – inside: “dont” – tooth) in which the living pulp tissues are housed, including the nerves. When a severely decayed or damaged tooth begins to hurt, it is because the pulpal tissues are inflamed or infected, and the response of the nerves is varying degrees of pain — letting you know something is wrong. If the pulp is dead or dying it must be removed and the root canal of the tooth is filled and sealed to stop infection and to save the tooth.

Who typically performs them?

Endodontics is a specialty within dentistry that specifically deals with the diagnosis and treatment of diseases and disorders of root canal issues affecting a tooth's root or nerve. While endodontists are dentists who specialize in root canal treatment, general dentists may also perform root canal treatment and are usually the dentists you will consult with when you first have tooth pain and who will refer you to an endodontist if necessary.

What are the symptoms of a root canal infection?

Root canal symptoms and the character of the pain may vary depending on the cause. For example, symptoms may be:

• Sharp, acute pain that is difficult to pinpoint
• Intense pain that occurs when biting down on the tooth or food
• Lingering pain after eating either hot or cold foods
• Dull ache and pressure
• Tenderness accompanied by swelling in the nearby gums

Does root canal treatment hurt?

A common misconception is that a root canal treatment is painful when, in actuality, it is quite the opposite. The pain associated with a root canal occurs prior to treatment and is relieved by it — not visa versa.

If you have tooth pain, you may or may not need a root canal treatment. Contact us today (before your symptoms get worse) and schedule an appointment to find out what's causing the problem. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “Common Concerns About Root Canal Treatment.”

An important consideration prior to having any cosmetic dentistry is to understand both the pros and the cons of each particular dental procedure. And while porcelain laminate veneers are among the most aesthetic means of creating a beautiful, more pleasing smile, they are permanent and non-reversible and should be maintained properly.

On average, you can expect porcelain veneers to last anywhere between 7 and 20+ years. However, much of that depends whether or not you care for them properly in addition to the quality of the dental porcelain, the craftsmanship, and placement of them. How long your veneers last can also depend to some extent upon how you age. This is because the gum tissues attached to the living tooth that your veneers are cemented to may shrink or pull away from the tooth exposing its root surface. If this occurs, you should see your dentist for an evaluation, as it may require veneer replacement. Or, the issue might be resolved through some minor periodontal (gum) plastic surgery.

Porcelain veneers are a low maintenance solution for solving a multitude of cosmetic dental challenges, but they do require that you protect them during sports or vigorous activity. You should also wear an oral appliance or mouthguard (nightguard) to protect them from grinding or any other involuntary damage during sleep.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Porcelain Veneers.” If you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.

Oral sedation can be an ideal and safe solution for someone who suffers from fear and anxiety regarding dental appointments — the very reason we offer it to our patients. However, there are some things you need to do prior to and following your treatment for optimal oral sedation benefits and treatment results.

• Being completely honest about your health history and any medication you are taking is a critical aspect, as it lets us know that oral sedation medication is safe and will work for you. We also ask you to let us know about any over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. The reason this is so vital is that some can negatively impact your treatment, recovery, and the effectiveness of the oral sedation medications.
• You should not eat or drink anything six hours prior to your appointment unless we instruct you otherwise.
• You should make arrangements to have someone drive you to and from your appointment, as it may not be safe for you to drive or operate any heavy machinery until the effects of oral sedation have worn off. It is important to note that this will vary depending on what medication is used, so do not assume your reaction/response will always be the same.
• Drink plenty of fluids (especially water) to stay hydrated after your appointment.

To learn more ways you can prepare, read the article “Oral Sedation Dentistry.” Or you can contact us today to discuss your questions or to schedule an appointment.

What is orthodontics?

Orthodontics is a sub-specialty of dentistry devoted to the study of growth and development of the teeth and jaws and treatment of improper bites (malocclusions).

What causes improper bites?

Malocclusions result from irregularities in the positioning of teeth, disproportionate jaw relationships, or both.

Why have orthodontic treatment?

Orthodontic treatment is carried out primarily to improve the alignment and function of your teeth and bite. It also results in improved oral health, easier maintenance, a better smile, and enhanced self-confidence and esteem.

What is the first step?

Schedule an appointment with our office for an orthodontic evaluation of your teeth and jaws and learn what options are best for you.

Contact us today to schedule an appointment or to discuss your questions about orthodontics. You can learn more by reading the Dear Doctor magazine article “The Magic of Orthodontics.”

If you are unhappy with the appearance of your smile and would like to change it, we can help you determine what will work best, from a simple whitening to brighten your smile to a complete smile makeover — the possibilities are almost limitless! Consider a “Smile Design” customized just for you. One method of improving your smile is with porcelain veneers. Porcelain laminate veneer tooth restorations are thin layers of dental ceramic — a glass-like material created by dental laboratory technicians, the “artists” who exactly mimic natural teeth making them straighter, whiter, and brighter. They are used to replace worn, dull-looking stained enamel. In addition to making your teeth and smile whiter and brighter, veneers can even be used to change tooth shape and color, close small spaces, and reshape slightly crooked or mis-shapen teeth.

In order to determine if porcelain veneers are a viable solution to help you achieve the smile you have always longed for, consider the following questions:

• Do you want to permanently alter the appearance of your smile?
• Are you hoping to make improvements to your smile that don't take a very long time to complete?
• Are you looking for a way to improve your smile with minimal or even no removal of your natural tooth material?
• Would you like to have more evenly aligned teeth?
• Do you want to change the color of your teeth?
• Do you want whiter teeth and a brighter smile?

If the answer to one or more of these questions is yes and whitening or other treatments have not given you the smile you want, we can help you assess the feasibility of porcelain veneers as one of the many options to enhance and improve your smile. We can fully discuss all the benefits, risks, alternatives, and costs associated with improving your smile.

Call us to make an appointment for a Smile Design consultation and we can get started. If you would like to read more information about porcelain veneers, as well as see a few before and after photos, read the Dear Doctor magazine article “Smile Design Enhanced With Porcelain Veneers.”

What causes stains on teeth?

Staining can occur on the outside surfaces of teeth and is caused by foods such as red wine, coffee, and tea, as well as by tobacco use. They can also be developmental, affecting the structure of the teeth due to excessive fluoride levels or from tetracycline antibiotics given during childhood to name a few. Changes in a tooth's enamel or dentin during tooth formation, or as teeth age, can also cause discoloration.

What is going on inside a tooth's structure that makes it look stained?

Most of a tooth's covering (95 percent) is composed of highly mineralized enamel. The crystals of enamel are contained in a framework, or matrix, of organic matter. Dentists believe that various organic compounds that get into this matrix can cause staining.

How do whiteners work?

Tooth whiteners or bleaches expose the teeth to a peroxide compound. This creates reactive oxygen that breaks down highly colored organic compounds within the tooth's sub-surface matrix, making the tooth look whiter, but without changing its internal structure.

What professional in-office whitening techniques are available?

During treatment, a high concentration of peroxide solution in the form of a gel is applied directly on the teeth, often with activation by a heat or light source. These systems use custom tailored trays fitted to an individual's mouth. Silicone barriers or protective gels are used to keep the peroxide gel away from the gums or sensitive membranes in the mouth.

How are professional home whiteners different?

Home whiteners involve a less concentrated solution of peroxide in a gel form. It is delivered to the tooth surface by a bleaching tray that is custom-made in your dentist's office. Over-the-counter whiteners such as whitening strips or paint-on formulas can also be used, but they take longer and they're not as effective — the more diluted solutions are used for safety.

Can toothpastes really whiten teeth?

Mild abrasives in toothpastes clean surface stains but cannot change the underlying tooth color or remove significant staining.

How long do the results last?

Usually, the results last from six months to two years, but effects will diminish over time. You can make them last longer by avoiding the foods and habits that cause staining.

Are teeth whiteners safe to use?

Teeth whitening products are safe if used according to our recommendations or the product manufacturer's directions. Peroxide products may be toxic if used in excess of recommended intervals and amounts.

Read more about teeth whitening in the article “Teeth Whitening, Brighter, Lighter, Whiter...” Contact us today to schedule an appointment or to discuss whether tooth whitening is right for you.

For adults with a reasonably well fitting bite, but mild to moderate crowding or spaces between your teeth, clear orthodontic aligners can be an ideal solution for straightening your teeth. This is why we offer this treatment option to our patients experiencing these issues. However, for those of you who are unfamiliar with what they are or how they work, this will give you a brief understanding.

Clear orthodontic aligners consist of a series of clear “trays” that fit snuggly over all teeth to slowly shift them into alignment. Patients are typically required to wear them 20 hours per day for about 2 weeks before progressing to the next tray. With each new tray, you are one step closer to achieving your goal of perfectly aligned teeth. The entire process usually lasts 6-18 months depending on how much movement is required to achieve the goals.

Each aligner is individually made from very precise molds of the patient's teeth to ensure proper fit. And we map out the entire alignment process using computer generation from each patient's initial molds so that we can identify the number of trays required. But best of all, clear orthodontic aligners are perfectly smooth with no rough edges like traditional braces, and you can remove them for eating, brushing, and flossing teeth as well as for brief social events.

To learn more about this topic, read the article “Clear Orthodontic Aligners.” Or you can contact us today to discuss your questions or to schedule an appointment.

If you are insecure about your misaligned crooked teeth, then you may be a perfect candidate for clear orthodontic aligners. This system is an alternative to traditional braces that uses a sequence of individual, clear, removable “trays” that fit over your teeth to gradually straighten them. Each tray is completely clear and covers all the teeth thus making it virtually invisible. Each tray is designed to slightly move the teeth until the teeth are in proper alignment. Typically, each tray must be worn for 20 hours a day for 2 weeks before progressing to the next tray in the sequence with each tray moving you closer towards your goal — perfectly aligned teeth.

However, clear orthodontic aligners are not for everyone. If you are interested and wonder if they can benefit you, contact us so that we can schedule an appointment for a thorough evaluation to assess your specific situation. Below, we have briefly outlined some situations when they will and will not work.

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about this topic by reading the article “Clear Orthodontic Aligners.”

When speaking about veneers in dentistry, many people wonder what they are really made from and how they produce such natural results. The answer is dental porcelain...and yes, it really is a type of porcelain or glass. Even though they are made of porcelain, not all porcelains are the same. This is one reason there can be such a wide price range when comparing porcelain veneer pricing from one dentist to another. For example, the quality of the dental porcelain used and the expertise of the dental lab artisans greatly impact the price of a veneer — just like other pieces of fine art, pricing depends upon the materials used and the artistry of the person creating them.

Dental porcelains are used to create veneers because of their near ideal optical properties in mimicking natural teeth in shine, opacity, and translucence. And when you combine these facts with the artistry of the lab technician and your dentist skill's in placing the veneers, you begin to understand how veneers are virtually undetectable in cosmetically-enhanced teeth. Another reason for using dental porcelain is that they can be made in many colors, shades and translucencies to enhance the optical properties and natural beauty of whiter, brighter, and visually appealing teeth. However, do not let the word porcelain, fool you when it comes to durability. While veneers are not as strong as natural teeth they are not so fragile that you should worry about breaking or damaging them with normal wear and tear. However, you should avoid biting into extremely hard substances; using your veneers as a tool in lieu of scissors, tweezers, or pliers (you should not use your natural teeth as a tool either!); and twisting your veneers when biting into harder substances.

To learn more about veneers, continue reading, “Smile Design Enhanced With Porcelain Veneers.” Or, contact us today to discuss your questions or to schedule a consultation.

The beloved title of “mother” unfortunately does not come with a manual. If it did, it would certainly contain a section in which mothers-to-be could learn about the impact that pregnancy has on both their general and oral health. For example, did you know that during pregnancy the normally elevated levels of female hormone progesterone can cause inflammation in blood vessels within the gum tissues making the gums bleed? It typically occurs in response to less than adequate daily oral hygiene; however, it is just one important fact that all pregnant women should know.

There are numerous studies that have revealed that oral health during pregnancy can have a significant impact on the child growing inside you, and in particular, it has a direct relationship on your baby's developing and future oral health.

Periodontal (gum) disease can also be a factor in your baby's birth weight. In fact, there are a variety of studies supporting a positive link between pre-term delivery and low birth weight babies in the presence of severe periodontal disease in pregnant women. And there is also a correlation between the severity of periodontal disease and the possibility of an increased rate of pre-eclampsia or high blood pressure during pregnancy. This is another reason why it is important to see a dentist for an evaluation of your oral and dental health as soon as you know you are pregnant.

Please note that the goal of sharing these facts is not to scare you, but rather inform you so that you can be an educated mother-to-be. After all, you should be as healthy as possible for the most important job in the world and this includes both your oral and general health. Learn more about your body and discover the many relationships between mother and child as you read the Dear Doctor article, “Pregnancy And Oral Health.” Or if you want to schedule an appointment to discuss your questions, contact us today.

Tooth pain occurs when a trauma or infection triggers a reaction from the nerves inside a tooth's pulp chamber. The severity of the pain and its duration can vary depending on the underlying cause, which can include anything from a loose filling to an abscess. Ignoring symptoms not only results in unnecessary physical and emotional pain, but can also lead to more expensive dental treatment as problems become more complex. Make an appointment with our office today if you are experiencing any of the following symptoms:

• Sharp pain when biting down on food — This type of pain could be indicative of a cracked tooth, loose filling, or tooth decay that is affecting one or more of your teeth. We can remove decay and replace a loose filling, but if your tooth is cracked, we will have to determine the location and depth of the crack before formulating a treatment plan. In some cases, root canal treatment or even extraction may be necessary.
• Pain that lingers after eating hot or cold foods or liquids — Mild and short-term sensitivity (lasting only seconds or a minute) to hot and cold foods resulting from gum recession can often be soothed by using a fluoride toothpaste made for sensitive teeth. However, an inflamed tooth pulp or one that is dying due to severe decay could cause sensitivity that lingers for a long time after exposure. In this case, root canal treatment may be necessary to remove dying pulp tissue in order to save the tooth.
• Constant severe pain and pressure, swelling of the gums, and sensitivity to touch — Infections and/or abscesses can spread from the tooth pulp into the surrounding periodontal tissues and bone causing this type of pain. Root canal treatment will most likely be required.
• Dull ache and pressure on one or both sides of the face in the upper teeth region — The sinuses and upper back teeth share the same nerves, so, oftentimes, referred pain from sinus congestion or infection can feel like a toothache. A thorough examination can determine whether or not the pain is dentally related.

If you are experiencing tooth pain, call our office immediately so that we can begin to provide you with some relief. To read about other symptoms of tooth pain and possible treatment options, read the Dear Doctor magazine article “Tooth Pain? Don't Wait!”

People always wonder when it is appropriate to contact their dentist. To answer this, we have put together the following list to provide some guidelines for you and your family. However, your calls are always welcome! Our goal is simply to give you some clear scenarios that illustrate when you should give us a call or come in to our office.

For Bite Related Problems

1. Early or late loss of baby teeth.
2. Difficulty in chewing or biting.
3. Mouth breathing.
4. Finger sucking or other oral habits.
5. Crowding, misplaced, crooked or even missing teeth.
6. Jaws that shift, jaw joints that “pop” or “click” or are uncomfortable.
7. Any change causing speech difficulty.
8. Cheek or tongue biting.
9. Protruding teeth — large overbite.
10. Teeth that meet in an abnormal way or don't meet at all.
11. Facial imbalance or asymmetry.
12. Grinding or clenching of teeth.

For Injuries And Immediate Care

1. Knocked out permanent tooth: Call us immediately. You need to take action within 5 minutes of the injury for best results.
2. Injuries to lips, cheeks, tongue or gums that appear to require stitches: Call us for instructions as soon as possible.
3. Tooth injury — if a tooth has shifted from its original position: Call us to tell us you are on your way to our office and see us within 6 hours of the injury.
4. Chipped or broken tooth that is still in its original position: See us within 12 hours of the injury.
5. A knocked out baby tooth: Call us as soon as possible.
6. Bleeding without any significant tears in tissue that could require stitches: Call us for instructions.

What To Do Now

If any of the above describe you or another member of your family, then contact us today to discuss your questions or to schedule a consultation. You can also learn more about treating dental injuries by reading the Dear Doctor article, “The Field-Side Guide To Dental Injuries.”

A recent study revealed that on average there are 22,000 dental injuries in children under the age of 18. This alarming reality makes it clear that parents, caregivers, and coaches need to understand the risks for dental injuries so that they are best equipped to prevent them...or at least be prepared to manage one should it occur. The four most common categories for measuring risks associated with sports injuries are:

• Age: Age is an important factor when accessing risk. Sports-related dental injuries tend to spike during the teenage years. Recent research shows that children under the age of 13 tend to not be injured as often.
• Gender: Gender is probably the second most influential factor. The facts are that males top the list for experiencing dental injuries during sports or vigorous activities. However, more and more females are playing highly competitive and contact sports or activities; thus, their risk of injury is increasing.
• Shape and position of your teeth: Both the condition and positions of the teeth affect their risk of injury. More prominent or “buck” teeth are considered a higher risk for injury than teeth in a more normal position. Furthermore, 80% of all dental injuries involve the upper front teeth.
• Sports type: This last category is the one most often asked about, as parents, caregivers and athletes want to know which sports or activities have the highest risks for dental injuries. And while baseball and basketball top the list, the American Dental Association (ADA) has put together a comprehensive list of sports and activities. To review this list, read the Dear Doctor article, “Athletic Mouthguards.” The ADA also urges athletes to wear professionally-fitted mouthguards to protect against dental and facial injuries.

Knowing the above categories can help you assess your risk for a dental injury while playing in a sport or recreational activity. To learn more about sports-related dental injuries, read, “An Introduction To Sports Injuries & Dentistry.” Or if you have a traumatized, damaged, chipped or missing tooth from a sports or any other type of injury, contact us to discuss your situation or to schedule an appointment.

While we have gained recognition for our role in creating gorgeous smiles with porcelain veneers, the often overlooked or unknown key contributors in this process are the dental laboratory technicians. These behind-the-scenes artists are the trained professionals in the art of using dental porcelain to hand-craft veneers and crowns into near exact replicas of natural teeth in shine, opacity, translucence and shape.

Through the use of precise molds and excellent communication skills, we share detailed information with the laboratory technician to create veneers or crowns specifically for enhancing and improving your smile. In fact, communication must be so exact that it often demands correct lighting, cameras and computers to produce optimal results. This process also requires a variety of colors, shapes and translucency, created so that once we cement them into place, they appear as beautiful natural teeth. If your veneers are part of a smile restoration or makeover and you are getting them for several front teeth, the end results are typically brighter and whiter than your natural teeth. However, they must blend with surrounding teeth if those teeth are not also receiving veneers. So it is often recommended to have your natural teeth whitened before the veneers are replaced.

Good dental porcelains in the right hands can make for spectacular tooth imitations by mimicking tooth enamel perfectly. And now that you have these facts, you begin to understand all of the expertise, artistry, and the technology required by laboratory technicians to produce the most dazzling porcelain veneers.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Smile Design Enhanced With Porcelain Veneers.” Or if you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.

Snoring and Obstructive Sleep Apnea (OSA) is a condition that occurs when the upper airway (back of your throat) collapses or is blocked, causing significant airflow disruption. A person with OSA continues snoring at a regular rate but is interrupted by long silent periods during which there is no breathing for atleast 10 seconds or more. Believe it or not, this issue affects millions of people worldwide. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. And if you have OSA that is left undiagnosed and untreated you could fall victim to heart attacks, strokes, irregular heartbeat, high blood pressure, heart disease and even impotence. For these reasons, we feel it is important that you understand the real-world consequences that can occur if you ignore your OSA.

Reality is that most people are unaware that their dentist can be an excellent resource in helping to diagnose and treat OSA. However the first and most important step is to receive a proper, thorough examination and diagnosis with an appropriately trained physician and dentist. If after completing this process you are diagnosed with OSA, we will discuss treatment options. Some of these may include:

• Suggesting that you exercise and lose weight if you are overweight.
• Sleeping with a Continuous Positive Airway Pressure (CPAP) machine that provides pressurized air into your airways through a mask that covers both your nose and mouth while sleeping.
• Sleeping with a professionally made oral appliance or mouthguard that can reposition your lower jaw, tongue, soft palate and uvula (the dangling tissue in the top, back portion of your mouth) into a better position during sleep to relieve blockage.

If you are ready to discuss you questions and concerns about your snoring, or the snoring habits of another family member, contact us today to schedule a consultation. You can also learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.”

Are you are considering a cosmetic procedure such as porcelain veneers? To assist you in making this decision, we developed the following list of questions you should consider asking before getting porcelain veneers.

• Am I a good candidate for porcelain veneers?
• Can you show me examples of your work?
• How much will my veneers cost?
• Will my insurance cover any portion of my procedure?
• Do you offer any financing for my procedure or can you make any recommendations for financing?
• Can you create a computer-generated image or mock-up of what my new smile will look like?
• How will you chose what color to make my veneers?
• How long will it take from my initial consultation until I receive my final, permanent veneers?
• How much tooth reduction (drilling) will you need to do before placing my veneers?
• How do veneers attach to my teeth?
• Can you create a prototype or temporary veneers so that I can “test drive” my new smile before my permanent ones are made?
• What do I need to do to clean and protect my veneers?
• How long can I expect my veneers to last?
• If at some point in the future I decide I want my veneers removed, what can I expect?

We hope that the above questions help you obtain all the answers you need as you consider getting porcelain veneers. If you have other questions, concerns, or if you are ready to take the next step and schedule a consultation, please contact our office.

Planning a dream trip is something many people spend weeks, months or even years doing prior to their departure. However, in all of their excitement, they often forget about preparing for any “what if” dental emergencies that could occur while on the road. This is especially important if the trip will be overseas where you could face language barriers in addition to the concerns of finding qualified dental professionals you feel comfortable with treating an emergency.

The first and most important step you can take prior to departure is a proactive one: schedule an appointment with us for a thorough exam. (You should also do the same and schedule an appointment with your physician concerning your general health.) During this visit, be sure to let us know about your travel plans, where you will be going and what you will be doing so that we can ensure you are best prepared for your trip. For example, if you will be trying some new or high-impact activities, you may need a mouthguard to protect your teeth. Also, have any dental problems taken care of prior to traveling because pressure changes, especially during air travel, can cause pain in an untreated tooth.

As for seeking safe emergency dental care while you're traveling, here are some tips:

• Be sure to carry your travel information with you at all times, including the names and phone numbers of organizations to contact in case of a dental or medical emergency.
• Some good sources to contact in an emergency are:
• Friends or relatives that you are visiting in the area
• A local hotel concierge
• If traveling overseas, Americans living in the area or American military personnel; The International Association For Medical Assistance To Travelers, a network of doctors and medical institutions around the world (www.iamat.org; 716-754-4883); American Consulate or American Embassy in the country you are visiting; or if in Europe, the American Dental Society of Europe (ADSE; www.adse.co.uk; Phone: 011 44 141 331 0088)

And be sure to take our address with you on your trip. We would love to receive a postcard from you while you're traveling!

In today's fast-paced society, nearly everyone is looking for reliable solutions to resolve problems almost instantly. Unfortunately, in many situations, bad breath cannot be cured that quickly. This is why we want to provide you with the following rules of thumb for treating your bad breath.

• Use a soft-bristled brush and a proper technique to clean your teeth at least twice a day, in the morning when you wake and before you go to bed.
• Floss your teeth at least once daily to remove the bacterial plaque and food particles between your teeth, as these are two known causes of bad breath and tooth decay.
• Clean your tongue, as it can often be the main culprit with too many odor-producing bacteria living on its surface. To clean your tongue, use a tongue scraper obtainable from a local drug or discount store, or brush your tongue with your toothbrush. Remember, a healthy tongue should be pink in color and not have a yellowish or brownish coating.
• Chew a sugar-free gum that contains xylitol, a natural, sugar-free sweetener that actually has been shown to help prevent caries (cavities) while improving your breath.
• Change your eating and drinking habits. Drinking plenty of tap water will not only keep your mouth hydrated (a dry mouth is another cause of bad breath), but it also can help prevent caries if you live in an area with fluoridated water. And by adding plenty of crunchy fruits and veggies such as carrots, celery and apples, you stimulate the production of saliva; thus keeping your mouth moist and rinsed out.

And last but not least, you can contact us today to schedule a consultation for an examination, cleaning and treatment plan. Or, you can learn more when you read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.”

Before determining if a bridge or an implant will work best for you, here is some useful background information. There are two main parts to a tooth; the crown or part that you see above the gum line and the root portion that is below the gum line and encased in bone — the part that is replaced by a dental implant.

A dental implant is inserted into the jawbone during a surgical procedure. The implant is actually a titanium screw-like device that is placed in contact with the bone. During a 3 to 6 month healing period, it subsequently fuses to the bone. A crown made from dental porcelain, gold or a combination of both is then attached to the implant to mimic a healthy, normal tooth.

There are two critical reasons why implants are the preferred method for permanently replacing an adult tooth. The first is that they are less susceptible to gum disease and they are not subject to tooth decay. The second is that because they attach to the jawbone and not to the adjacent teeth. And while an implant may cost a little more initially, when compared to the longevity and replacement cost of bridgework over a lifetime, they may cost less.

By contrast, a fixed bridge is also a non-removable restoration or prosthesis (replacement part) that is held in place by attaching it to your natural adjacent teeth. The treatment gets its name from the French word for bridge, “pont,” as the tooth being replaced is called a pontic. Before placing a bridge, the teeth on either side of the missing tooth must be prepared by removing layers of tooth enamel. Three new teeth are then crafted as a single unit from dental porcelain and/or precious metals with crowns on either side of the pontic. The pontic is held in place when the crowns are placed. Bridgework is at risk for gum disease and tooth decay and requires careful maintenance.

As with most dental procedures you have options and choices. Luckily, when it comes to determining whether a bridge or an implant will work best for you, you can rely upon our expertise. However, by having a clear understanding of these two options you are now better prepared for working with us should you require this treatment option. To learn more read the article, “Implants Vs. Bridgework.” Or, contact usto discuss your questions or to schedule an appointment.

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.

As we move forward with our blog, we hope to promote dental awareness as a vital part of your healthy lifestyle. Here you will find a variety of articles and topics including dental news, advancements in dental technology and treatment, practical dental health advice and updates from Dr. Fennell and his staff.

We hope you find our blog to be helpful, engaging and informational to ensure your best dental health.
As always, feel free to contact us with any dental questions or concerns.

Designing a better smile sometimes requires a change in the size, shape, or color of your teeth. Porcelain laminate veneers (thin layers of dental ceramic material) enhance your appearance by replacing the natural enamel on the outside of your teeth. A veneer is physically bonded to the surface of a tooth, in essence, becoming part of it.

Traditionally, a small amount of the natural tooth enamel is drilled away to allow room for the veneer. But today, in some circumstances, it is possible to use an approach where enamel reduction or preparation is not necessary because the veneers can be bonded directly onto the tooth's natural surface. These are called “Prepless” or “No-prep” veneers, and are used to create aesthetically pleasing and natural looking restorations. An advantage of the prepless procedure is that the process is reversible so that you can give your new smile a “test drive.”

You may be a good subject for Prepless veneers if:

• Your smile is narrow because the teeth in the sides of your smile are positioned inward and do not show from a frontal view.
• There is spacing between your teeth, and the teeth appear too small.
• You have a fairly common genetic condition in which one or both of the teeth directly next to the two upper front teeth are very small and peg-shaped.
• There is an imbalance between the size of your lips and teeth (large lips and small teeth), which are not in proportion to show off your best smile.

Prepless veneers are probably not for you if:

• Your teeth are not aligned properly in your bite.
• Your teeth are very crowded, resulting in poor facial profile.
• Your teeth are already relatively large or positioned forward.

In these cases you may need to have some form of orthodontic treatment to move your teeth into better position. Sometimes veneers can be used to create an illusion of proper tooth alignment, but some amount of tooth reduction may be required.

We can assess whether prepless veneers are right for you. There is no substitute for an expert dentist's talent and expertise with the various cosmetic techniques available today. These skills combined with a thorough diagnostic evaluation, and a clear understanding of your goals, are the keys to providing you with a successful and beautiful smile.

Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can also learn more about prepless veneers by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”

In our office, many of our patients are always asking us if over-the-counter (OTC) mouthwashes or mouthrinses are truly effective tools for curing bad breath. Unfortunately, nearly all of them merely mask any odorous smells temporarily — regardless of how refreshing they taste. There are mouthrinses available that are effective for treating gingivitis and tooth decay, but you must visit our office to obtain a proper diagnosis and a prescription for them. Reality is that a mouthrinse alone can't cure bad breath; however, there are products available that can make a positive impact on your dental health. The key is to match the right mouthrinse to your specific dental need.

• OTC mouthrinses that contain about 0.05% sodium fluoride are an effective tool that when combined with good oral hygiene can significantly reduce the development of tooth decay.
• OTC mouthrinses that contain alcohol, triclosan, sanguinaria extract, zinc and/or essential oils such as menthol can somewhat help reduce the bacteria in plaque, which in turn can reduce gum inflammation (gingivitis) and bad breath when used in combination with proper brushing and daily flossing.
• Prescription mouthrinses containing chlorhexidine may be more effective in helping to control both gingivitis and tooth decay in certain circumstances. This is because chlorhexidine inhibits the formation of dental plaque by preventing bacteria from sticking to your teeth.

While bad breath may seem unbearable, it is often treatable. The key is to determine and then address what is causing your bad breath. A simple trip to our office for a proper exam, assessment and thorough cleaning along with improved oral hygiene may just do the trick. Contact us today to schedule a consultation for an examination and treatment plan.

Learn More

To learn more about mouthrinses, read the Dear Doctor article, “Mouthrinses.”

Your teeth were designed to last you a lifetime, so you should do everything you can to protect them. This includes guarding them against dental erosion. However, many people may not know for sure what dental erosion is, much less how or why they need to guard against it.

Dental or tooth erosion is the irreversible loss of tooth enamel from chemical attack by acids. Eating or sucking acidic foods such as lemons is a good example. But most people are shocked to discover that it can also be caused by their favorite sodas (carbonated beverages), natural fruit juices, energy and sports drinks — especially with excessive consumption. It takes the saliva, nature's protection, at least 30 to 60 minutes to neutralize the effects of acid, so only one acidic drink an hour causes your teeth to be continually bathed in acid. And this is an important fact to know, because if your mouth is acidic all the time, this will promote tooth decay.

Will brushing help out with prevention?

When it comes to dental erosion, brushing immediately after acid consumption can actually make it worse by accelerating the erosion process. This is because the acids in these drinks (and some foods) actually dissolves tooth enamel and softens the tooth surface. These newly softened surfaces can literally be brushed away if you brush before your saliva has a chance to try to reverse the process. If done often, you could even brush away your enamel! For this reason, you should wait at least 30 to 60 minutes before you brush your teeth after consuming any of these products.

So what can you do to prevent dental erosion?

One important step that you (and your family) can do to help prevent dental erosion is to limit the amount of these beverages you drink. Instead, try drinking calcium-rich milk or water and saving your favorite acidic beverage for a special treat that you consume preferably with a meal. Try reducing the number of these drinks you consume over a period of time. If you must drink an acidic beverage avoid swishing it in the mouth and use a straw to reduce the contact between the acid and your teeth.

Just remember that once your dental enamel has eroded, it is gone forever. So you should follow these simple tips now to protect your smile and future.

One of the most common treatments we are asked about is a root canal and the unfortunate bad reputation associated with it. The truth is that the procedure actually relieves the pain associated with the problem and not visa versa. And here's why.

A root canal or endodontic treatment (“endo” – inside; “dont” – tooth) is a necessary procedure in which diseased pulp tissue — and the nerve, which responds by causing the pain — is removed. This is followed by cleaning and sealing the root canals. This usually results from pulp inflammation and infection as a result of a severe decay or in a heavily filled tooth. Root canal treatment is typically performed by general dentists who have taken specialized training or by endodontists, dentists who specialize in the diagnosis and treatment of root canal problems. We perform them here in our practice to save a tooth, literally, from further damage and/or loss.

Here is a quick overview of the procedure. We will begin by making a small opening in the chewing surface of your tooth so that we can access the tooth's root canal. We use small instruments to remove the dead and dying tissues of the pulp. The root canals are cleaned and disinfected. The canals are then sealed with a biocompatible filling material. Lastly, we will seal the access hole with a filling material. You will then need to get a permanent restoration or crown to protect the tooth fully.

If you feel that you have the symptoms of a root canal problem and may need a root canal treatment, contact us to schedule an appointment. And to learn more about the signs, symptoms, and what to expect after root canal treatment, read the article “Common Concerns About Root Canal Treatment.”

Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

Often perceived as a cancer that only affects older adults who have a history of heavy tobacco and alcohol use, oral cancer is now on the rise among younger adults as well. New research has found a link between oral cancers, and the Human Papilloma Virus (HPV), a disease that is primarily spread through oral sex.

Importance of Screening: If you're concerned about oral cancer, rest assured that our office routinely carries out a cancer screening exam on every patient. We have several ways to painlessly detect abnormal tissues in their earliest stages. In addition, please contact our office if you experience any of the following signs or symptoms:

• White and/or red patches in the mouth or on the lips
• A bleeding or ulcerated sore in the mouth
• A sore anywhere in your mouth that doesn't heal
• Persistent difficulty swallowing, chewing, speaking, or moving your jaw or tongue

Although all of these symptoms can also be signs of less serious problems, be sure to alert our office if you notice any of the above changes.

Prevention: you can take a proactive role in preventing oral cancer by:

• Conducting an oral self-exam at least once a month. Use a bright light and a mirror, look and feel your lips and front of your gums, the roof of your mouth, and the lining of your cheeks.
• Scheduling regular exams in our office. The American Cancer Society recommends oral cancer screening exams every three years for people over age 20 and annually for those over age 40.
• Refraining from smoking or using any tobacco products and drinking alcohol only in moderation.
• Eating a well balanced diet.
• Practicing safe sex.

Contact us today to schedule an appointment to discuss any questions you may have regarding oral cancer. Read more about this topic in the Dear Doctor magazine article “Risk Factors for Oral Cancer.”

Lost teeth can cause a host of problems, including a loss of your jaw bone and a collapsing appearance of your face, along with difficulty chewing and speaking.

Clearly, it is important to replace missing teeth as soon as possible. Options for replacement include the more traditional methods and the newest technique — dental implants. We believe that implants are your best choice for the following reasons.

1. Implants prevent bone loss.

   Dental implants are substitute tooth roots. Like the roots of your original teeth, they stabilize the bone into which they extend — but in a different way.

   The part of the bone that encases the teeth is called alveolar bone, from the word root meaning “sac.” This bone has a special relationship with the teeth it surrounds. It develops as they first erupt into the mouth. If they are lost, the alveolar bone goes, too. It resorbs, or melts away, giving an impression that the bone, gums, and sometimes the lips are collapsing.

   Implants are made of titanium, which has the ability to join biochemically to bone. It takes the place of the original tooth root and prevents resorption.

2. Implants support adjacent teeth.

   Your teeth work in harmony, an all for one, one for all relationship with each other. If one is missing, the remaining teeth will slowly move and shift causing them to receive forces that may not be well received. Losing any tooth increases the pressure on the remaining teeth. Losing a back (posterior) tooth can put pressure on the front teeth and they can be forced out of position. All these movements can change a person's appearance as well as in their ability to speak, bite and chew.

3. They are easier to clean than “traditional” options.

   Fixed bridges are non-removable tooth replacements that attach to adjacent natural teeth. These teeth that are adjacent to the missing tooth have to be cut into small peg shapes on which the bridge is attached. The removal of their enamel may make them more prone to tooth decay and gum disease.

   Older replacement methods include removable options such as plastic “flippers” and partial dentures. These replacements rest on the teeth and gums, making the teeth they attach to receive greater pressure causing more mobility. In addition, they exert pressure on the gums, causing additional bone loss and increasing the potential for bone loss on the neighboring teeth.

   Full dentures, in cases where all teeth are missing, are kept in place by pressing on the gum tissues. This causes even more pressure on the bone, leading to bone loss and changing facial structures.

4. They are longer lasting.

   Studies have shown that removable partial dentures are replaced about every five years; bridges are only 67% successful at 15 years; and implants are over 95% successful for 20 or more years.

5. They are cost effective in the long term.

   Because implants last longer than other alternative tooth replacements, they may seem more expensive at first; but they will be cost effective over the long term.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Dental Implants. Evaluating Your Options.”

Time to tune up the brightness on your teeth? Here are six modern methods of whitening and brightening your smile.

• In-office “power” bleaching under the supervision of my staff and me is recommended if your teeth are badly stained, or if you are about to have veneers or crowns made. It's quick, safe, and effective. Gels containing high concentrations of bleach are applied to your teeth in our office, often with the enhancement by heat and light to make them act faster. Results show teeth becoming up to ten shades lighter in about an hour.
• “Take home” whitening solutions and trays are designed to fit your mouth and can also be provided by my office. The technique is easy to perform and is less expensive than in-office power whitening system, although it takes longer to see the same results. General recommendations are for 30 minute applications twice a day. You can usually see a change after two to four sessions. This requires patience, because it is important not to exceed recommended exposure in order to avoid damage to your teeth, gums, and the inside skin of your mouth. After two weeks of use, teeth can be expected to be about eight shades lighter.
• Whitening strips look like clear Band-Aids that are applied to the tooth surfaces. They should be worn twice a day for 30 minutes each time, for seven days. On average, they claim to lighten teeth more than three shades. They take about two weeks to work at 30 minutes per day.
• “Paint on” or “Brush on” whitening formulas are also available. These are gels that are painted onto the teeth every night at bedtime, for two weeks. Some claim that this line of home whitening can whiten teeth two to five shades. These gels may make your mouth feel goopy, but they are relatively inexpensive. Some gels come with a small brush to scrub them onto the teeth.
• Over-the-counter “mouth-tray” whiteners use mouth trays that are not designed for your particular mouth, so they may not fit well and may be messy or uncomfortable. They are filled with gel and worn 45 minutes a day for one week. On average, teeth become two shades whiter.
• Whitening gum is a relatively new product. It requires chewing two pieces for at least 20 minutes, four times a day, to see an effect.

Contact us today to schedule an appointment to discuss your questions about tooth bleaching. You can also learn more by reading the Dear Doctor magazine article “Teeth Whitening.”

Gum disease, also called periodontal disease (from the roots for “around” and “tooth”) starts with redness and inflammation, progresses to infection, and can lead to progressive loss of attachment between the fibers that connect the bone and gum tissues to your teeth, ultimately causing loss of teeth. Here are some ways to assess your risk for gum disease.

Your risk for developing periodontal disease is higher if:

1. You are over 40.
   Studies have shown that periodontal disease and tooth loss correlate with aging. The longer plaque (a film of bacteria that collects on your teeth and gums) is allowed to stay in contact with your gums, the more you are at risk for periodontal disease. This means that brushing and flossing to remove plaque is important throughout your lifetime. To make sure you are removing plaque effectively, come into our office for an evaluation of your brushing and flossing techniques.
2. You have a family history of gum disease.
   If gum disease seems to “run in your family,” you may be genetically predisposed to having this disease. Your vulnerability or resistance to gum disease is influenced by genetics. The problem with this assessment is that if your parents were never treated for gum disease or lacked proper instruction in preventative strategies and care, their susceptibility to the disease is difficult to accurately quantify.
3. You smoke or chew tobacco.
   Here's more bad news for smokers. If you smoke or chew tobacco you are at much greater risk for the development and progression of periodontal disease. Smokers' teeth tend to have more plaque and tartar while also having them form more quickly.
4. You are a woman.
   Hormonal fluctuations during a woman's lifetime tend to make her more susceptible to gum disease than men, even if she takes good care of her teeth.
5. You have ongoing health conditions such as heart disease, respiratory disease, rheumatoid arthritis, osteoporosis, high stress, or diabetes.
   Research has shown a connection between these conditions and periodontal disease. The bacteria can pass into the blood stream and move to other parts of the body. Gum disease has also been connected with premature birth and low birth weight in babies.
6. Your gums bleed when you brush or floss.
   Healthy gums do not bleed. If yours do, you may already have the beginnings of gum disease.
7. You are getting “long in the tooth.”
   If your teeth appear longer, you may have advancing gum disease. This means that infection has caused your gum tissue to recede away from your teeth.
8. Your teeth have been getting loose.
   Advancing gum disease results in greater bone loss that is needed to support and hold your teeth in place. Loose teeth are a sign that you have a serious problem with periodontal disease.

Even with indications of serious periodontal disease, it can still be stopped. Make an appointment with us today to assess your risks. You can also learn more by reading the Dear Doctor magazine article “Assessing Risk for Gum Disease.”

When a device meant to make your life easier doesn't function properly, it can be extremely frustrating. This is sometimes the case for people who wear lower dentures, which loosen over time. These removable replacement teeth can become less reliable and more uncomfortable. Why does this happen?

The answer is bone loss. When a tooth is lost, the bone surrounding it deteriorates and this will change the shape of the jawbone in your mouth. You may find that a lower denture that once had a snug fit on your lower jaw is now sliding around. This happens more often on the bottom because your muscular tongue pushes against the denture. Also, a top denture has more surface area due to an artificial palate to help create suction to the roof of the mouth and keep it in place.

Dental implants, which permanently replace the roots of teeth, do not loosen and they also prevent bone loss. But replacing a whole set of bottom teeth with dental implants and crowns is expensive. What to do?

There's a relatively new solution that combines the security of implants with the affordability of a removable denture. It's called an overdenture, and it may be something you want to consider. An overdenture is a lot like the removable lower denture you already have, only it fits over two implants strategically placed in your lower jaw. While the lower denture is still removable, its stability is greatly improved.

Studies have shown that people with two-implant overdentures have a higher quality of life, and receive better nutrition, than those wearing conventional dentures. It's not hard to figure out why: A more stable denture makes it easier to eat healthy foods such as vegetables — or, really, any foods — and prevents embarrassing slippage of false teeth.

If you are tired of living with a wiggly lower denture, contact us to discuss two-implant overdentures, or to schedule an appointment for a consultation.

You can read more about this topic in the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”

One topic we are often asked about is finger or thumb sucking and/or pacifier use — a challenge that most parents or caregivers will likely face with at least one of their children. The first and perhaps most important thing to remember is that it is totally normal for babies and young children to suck their fingers, thumb or a pacifier. It only becomes a problem when it continues as the child ages or if you unnecessarily make it a problem.

For most children, the sucking instinct starts in the womb before birth. This fact is evident, as many expectant mothers are shown their child sucking fingers or a thumb during a mid or late-term sonogram. Once the child is born, the habit may continue because it provides the child with a sense of security. Other research indicates that some babies start sucking habits as a way to make contact with, test and learn about their new world outside the womb. It is interesting to note that most children typically tend to stop finger or thumb sucking habits on their own and without much intervention between the ages of two and four. However, for others it can continue much longer. And that is the scenario that parents and caregivers need to be aware of so that they can monitor sucking habits.

Children who suck their thumbs or a pacifier after the age of two have a higher risk of developing some long term negative effects from the habit. This includes but is not limited to upper jaw development issues and “buck” teeth (upper front teeth that protrude forward out of a natural position towards the lips). For this reason, some researchers feel that children should cease thumb or finger sucking and/or pacifier use by 18 months of age. However, the Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to cease this habit by age three.

If you feel your child is at risk due to his/her age and habits, please contact us today to schedule an appointment for your child. After a thorough exam, we can work with you to create a strategy for helping your child overcome finger, thumb or pacifier habits. To learn more about this topic, continue reading the Dear Doctor magazine article “Thumb Sucking in Children.”

Of all the teeth in the mouth, the ones receiving the most discussion and controversy would have to be the wisdom teeth or third molars. And this is not just a recent phenomenon, as people have been discussing them for centuries! See how much you really know about wisdom teeth by taking our quick and easy true/false self test.

1. Third molars received their name, “wisdom teeth,” because a moderate amount of wisdom is supposedly achieved in life about the time they appear.
   True or False
2. Wisdom teeth and all of their associated problems are commonplace in the practice of dentistry.
   True or False
3. Because wisdom teeth are so unpredictable, they typically make their appearance between the ages of 17 and 25.
   True or False
4. The most common consequence of impacted wisdom teeth is gum (periodontal) disease.
   True or False
5. If wisdom teeth are not removed, they will become impacted or cause crowding. This is why so many people require orthodontic treatment (braces).
   True or False
6. While most people have four wisdom teeth, having more (supernumerary teeth) or less (hypodontia) is possible.
   True or False
7. Through dental x-rays and routine check-ups, we can predict the timing and way in which wisdom teeth become visible (erupt).
   True or False
8. An impacted wisdom tooth, by definition, is a third molar that is colliding with or jammed against another important structure, such as an adjacent tooth, the gums or other important soft tissues in the mouth, or nerves and blood vessels.
   True or False
9. The primary symptom for indicating you have an impacted wisdom tooth is pain.
   True or False
10. If wisdom teeth need to be removed, it is best to remove them at a younger age rather than waiting until periodontal disease has started.
    True or False

Answers: 1) True. 2) True. 3) True. 4) True. 5) False. While wisdom teeth can be a factor in crowding, some people have no issues with these teeth. For them, they grow into proper position and are healthy teeth. 6) True. 7) False. Unfortunately, it is not possible to predict the way wisdom teeth will erupt. 8) True. 9) False. In some scenarios, impacted wisdom may cause no pain. 10) True.

To learn more about wisdom teeth and in particular, impacted wisdom teeth, continue reading the Dear Doctor magazine article “Wisdom Teeth.” Or you can contact us today to schedule an appointment to discuss your questions.

The third molars, called “wisdom teeth” because they usually become visible when a person is 17 to 25 — supposedly the time we achieve wisdom, may have adverse effects on adjacent teeth. Most adults have four wisdom teeth, although some people have more; and some, none at all. The wisest thing to do about wisdom teeth may be to have them removed if they are poorly positioned.

What is an impacted wisdom tooth?

If a wisdom tooth is pushing against gums, other soft tissues, or adjacent teeth at an awkward angle, it is referred to as “impacted.” Usually this occurs when there is not have enough room in the jaws for these last molars to fit next to their adjacent teeth. They can disrupt the gum tissue attachment of their neighboring teeth and the surrounding bone leading to periodontal disease and, ultimately, their loss.

In many cases, impacted teeth are painless, and those who have them have no warning of the problem. Thus it is important to have routine dental exams during the time when the third molars are coming in.

When should wisdom teeth be removed?

It is better to remove wisdom teeth early rather than waiting until periodontal (gum) disease has set in. As individuals age, keeping their wisdom teeth may lead to more serious problems. Periodontal defects tend to get worse in the presence of retained third molars. Furthermore, there is a higher incidence of postoperative symptoms in people over 25.

What are the pros and cons?

Removing impacted third molars can have a negative influence on the periodontal tissues of adjacent second molars. A number of techniques, such as scaling, root planing, and bacterial plaque control, can be used to minimize periodontal problems and promote healthy healing.

Surgical removal of wisdom teeth will involve some mild to moderate post-operative discomfort. Use of aspirin or ibuprofen for a few days after surgery will provide pain relief and control most swelling and symptoms. Antibiotics may be prescribed to ensure infection-free healing. It is important to keep the socket area clean by washing and rinsing with saline or antibacterial rinses. Careful surgery will promote good healing with minimal periodontal consequences to adjacent second molar teeth.

To decide whether your wisdom teeth should be removed, you will need an evaluation to assess the clinical health of the wisdom teeth, the neighboring teeth, and other vital structures. X-ray and digital imaging techniques play an important role in determining the exact position of the wisdom teeth in the jaw. A full assessment and consultation will include all the risks, benefits, likely consequences, and alternative treatment options. This will provide you with the wisdom you need to determine what is best for your wisdom teeth.

To learn more about wisdom teeth, read “To Be or Not to Be: What are the consequences of an impacted wisdom tooth?” Or contact us today to discuss your questions or to schedule an appointment.

Snoring and other sleeping disorders impact between 50 and 70 million Americans each year. However, did you know that our office can help when it comes to diagnosing and treating sleeping disorders? For this reason, we have put together this list to highlight how we can have a positive impact on your snoring.

1. Many people are surprised to learn that physician training is lacking and very slowly evolving in the area of sleep related breathing disorders. Therefore, there is limited public and medical awareness. The American Academy of Sleep Medicine (AASM) has acknowledged that properly trained dentists are the first line of therapy for treating mild to moderate sleep apnea effectively.
2. Because we see our patients on a more regular basis than many primary-care physicians, we dentists are in a unique position to identify and/or detect a SRBD. However, for us to accomplish this, you must share the facts about your sleeping habits and issues related to breathing. In other words, do not be embarrassed to let us know that your spouse, sleeping partner or family complain to you about your snoring!
3. When it comes to treating complications associated with Oral Appliance Therapy (OAT) used in managing Sleep Related Breathing Disorders (SRBD), dentists are the primary professionals who are specifically trained to create, fit, adjust, monitor and treat any complications associated with a mouthpiece (oral appliance).
4. Did you know that dentists help identify the approximately 90% of misdiagnosed cases of patients suffering from a SRBD? Well, it is true. We play a critical role in diagnosing and treating these patients.
5. Another reason why it is much easier for us to diagnose and treat these problems is because the core of our training is centered upon the oral cavity, mouth and parts of the upper airway — the very areas where your snoring and SRBDs occur.

If you suffer from snoring or any other Sleep Related Breathing Disorder, it is imperative that you seek and obtain treatment. Ignoring these problems can lead to issues such as: an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease as well as strokes and impotence. Contact us today to discuss your questions about snoring or to schedule an appointment. You can also learn more about snoring and sleep disorders when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

When treating Temporomandibular (jaw joint) Disorder (formerly known as Temporomandibular Joint Disorder, TMJ), we feel we have two equally important challenges facing us. First, we must start your treatment by relieving the symptoms of pain and discomfort. We typically accomplish this with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. Once we have begun to relieve your pain, our second critical objective is to identify and remedy what is causing the pain. It could be the result of an injury or trauma to the jaws and/or teeth or it could be due to a bite issue or a filling or crown that is too high and thus causing a misaligned bite. There are many other reasons, so it is first necessary to obtain a thorough medical history and conduct a comprehensive evaluation so that we can properly diagnose and treat the TMD condition and what is causing it.

Next to stress resulting in clenching and grinding habits, the four most common causes leading to TMD include:

• Underlying dental conditions that are triggering muscle pain
• Internal joint derangement (displaced or improperly positioned jaw joint)
• Osteoarthritis (degenerative joint disease)
• Synovitis — the painful inflammation of a synovial joint-lining membrane that is characterized by swelling, due to effusion (fluid collection)

If you or another family member suffer from chronic jaw pain, please let us know so that we can properly address your concerns and conduct a thorough examination. Or if you are in constant or severe pain, contact us as soon as possible to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

In times of stress, people have many ways to comfort themselves. For adults, it can be habits such as eating, drinking, or smoking. For children, it is often sucking their thumb, fingers, or a pacifier. Babies have been observed in scans to suck on their fingers and thumbs even before they are born. It makes them feel secure.

When is thumb sucking a problem?
Sucking on fingers or thumbs can be a problem when it is done too vigorously and too long. A young child's jaws are soft and can change their shape to make room for the thumb if the child sucks too hard and too often. If thumb, finger or pacifier habits continue too long, the upper front teeth may tip toward the lip or not come into the correct position in the mouth.

How do you know if your child falls into the group that will suffer from the results of too much thumb sucking? It's best to visit our office so we can check on how the child's teeth and jaws are developing.

What can be done about thumb and finger sucking?
Most children naturally stop sucking their thumbs, fingers, or pacifiers between the age of two and four. The pacifier habit is easier to break than the thumb or finger sucking habit, probably because it is always easier to find their fingers or thumbs. It is a good idea to try to transfer your child's habit to a pacifier at an early age. The next steps are to cut down pacifier usage and gradually stop by 18 months.

If your child is still engaging in these habits at age three, we can recommend strategies for cutting back and stopping. Remember that positive reinforcement, in which a child is rewarded for the desired behavior, always works better than punishment for the behavior you don't like.

Also remember that finger and thumb sucking is normal. Help your child to feel safe, secure, and comfortable as the behavior will probably disappear by itself. If you are worried about your child's sucking a pacifier, thumb or fingers, please visit us to put your mind at rest.

Contact us today to schedule an appointment to discuss your questions about children's thumb sucking. For more information, read “Thumb Sucking in Children” in Dear Doctor magazine.

Every parent, caregiver, coach, sports fan and especially injured party dreads the moment when an injury to the mouth occurs during a sporting event. The first thought observers have after looking closely to see if it is their child or someone they know is, “I hope someone knows what to do!” Do you know what to do in case of a dental sports emergency? Test your dental injury IQ with this simple, quick quiz. The answers are listed at the bottom of this article.

Dental Injury IQ

1. If a tooth (including its root) is totally knocked out, what can you safely store it in while finding a dentist within 5 minutes of the injury?
1. Water or salt water
2. Milk (preferably cold)
3. Inside the cheek (mouth) of the injured person
4. All of the above
2. True or False: Immediately following the injury, fresh cold tap water or bottled water is the best way to remove debris from where a tooth was knocked out.
3. If a tooth has shifted from its original position following an injury, you should...
1. See a dentist within 5 minutes
2. See a dentist within 6 hours
3. See a dentist within 12 hours
4. Only see a dentist if the tooth is not better in a few days
4. True or False: You treat a knocked out baby tooth in the same manner as you do a permanent tooth.
5. The most important thing to do to save a tooth that has been completely knocked out of the mouth is to…
1. See a dentist as soon as possible
2. Replant the tooth within 5 minutes
3. Stop the bleeding before re-planting the tooth
4. Rinse the tooth with fresh, clean water

The Answers

1) d = all of the above, 2) true, 3) b = see a dentist within 6 hours, 4) false – baby teeth are typically not replanted, 5) b = replant the tooth within 5 minutes

Want To Learn More?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about treating dental injuries when you read the Dear Doctor article, “The Field-Side Guide To Dental Injuries.” Or, you can download a FREE, pocket-sized guide for managing dental injuries.

Creating a dental crown that looks good and wears well is not an easy achievement. It is the result of good communication you, the patient, have with us, your dental professionals, and that we have with the dental lab that manufactures the crown. In addition, it reflects the quality of work done by us and by the lab technician.

What is a dental crown?
A crown is a dental restoration that surrounds the remains of a damaged tooth or is attached to a dental implant so that it resembles a natural tooth as it extends above the gum line. The choice of materials and appearance of the crown depend upon many factors. One is the location of the crown. If it is in the back part of your jaw, strength and wear will be a major factor. If it is in the front, a life-like appearance will be important.

What goes into making a good-looking and functional crown?
Options for crown materials include porcelain, gold, porcelain fused to metal (called PFM) and some newer materials such as “pressed-ceramic” restorations and computer-milled-ceramics.

You as the patient can have a say in choosing the crown's color and appearance. Before it is cemented into its final position, make sure you are happy with the feel and appearance of your new crown.

Gold is often chosen for crowns on back teeth because of its superior wear qualities. Gold crowns have been known to last more than 50 years. They also cause minimal wear to the teeth that they touch on the opposing jaw.

Crowns made of porcelain (a glass-like substance fired in an oven at a high temperature) look good but may be too brittle to stand the wear and forces given to back teeth. Like glass, they can fracture under pressure. But because of their lifelike appearance they make a good choice for visible front teeth.

PFM (porcelain-fused-to-metal crowns) are a good combination of the best of gold and porcelain, but they sometimes lose the stains applied to make them look natural, and occasionally they fracture away from the metal.

A provisional crown can help you make sure you are getting a crown with the qualities you want. With the provisional crown all the details are worked out ahead of time, and you get a chance to try them out to make sure the crown looks good and that you can eat and talk normally. After you give your approval on the provisional crown, the final crown will be made to match it, in longer-lasting and better quality components.

Contact us today to schedule an appointment to discuss your questions about crowns and other dental restorations. You can also learn more by reading the Dear Doctor magazine article “Gold or Porcelain Crowns.”

No one participates in sports or recreational activities with the goal of oral or facial injury. However, the facts reveal two things: sports injuries are the number one cause, impacting thousands of adults and children annually and many of them can be prevented or at least minimized with education and the use of a properly fitted professional mouthguard.

In addition to the obvious negative of the physical injury to the mouth and face, oral-facial injuries can also be both emotional and psychological. And while these injuries can occur due to a multitude of reasons, a recent study found that approximately 25% occur while playing sports. The following poignant facts should raise your awareness of dental injuries.

Did you know…?

• On average, 22,000 dental injuries occur annually in children under the age of 18.
• Outdoor activities and products are associated with the largest number of dental injuries to baby (primary) teeth in children aged 7 to 12 with 50% of these incidents related to bicycle accidents.
• Outdoor activities and products are also associated with the largest number of dental injuries to permanent teeth in adolescents aged 13 to 17.
• Of all sports, baseball and basketball consistently produce the largest number of dental injuries each year.
• Over 80% of all dental injuries involve the upper front teeth.
• Age, gender, condition and position of the teeth, as well as the type of sport being played are all key risk factors associated with the likelihood of experiencing a sports injury.
• Studies show that teenage boys involved in contact sports, collision sports, and high-velocity non-contact sports are at the highest risks for dental injuries.
• Young girls are starting to participate in many of these same sports, and thus their risks for injuries are climbing.
• Home furniture is the main culprit in over 50% of the dental injuries in children under the age of 7.

We encourage you to take a moment to assess your own as well as your family's risk of dental injury and to think about how you can treat and prevent them. To learn more, read the Dear Doctor article, “An Introduction To Sports Injuries & Dentistry.” Or, feel free to contact us to discuss your questions or to schedule a consultation.

When involved in high impact sports or vigorous activities, it is important to protect your mouth and teeth. This statement is backed by the fact that there are over 600,000 sports-related dental injuries treated in emergency rooms across the US each year according to the US Centers for Disease Control (CDC).

In addition to absorbing and distributing the forces that impact the mouth, teeth, face and jaws an athlete receives while participating in sports such as baseball, football, basketball, hockey (ice and field), skateboarding and wrestling, the American Dental Association (ADA), also recommends the use of custom mouthguards for other activities such as acrobatics, bicycling, handball, racquetball, skiing, and even weightlifting.

These facts make two things clear: (1) it is vital that you obtain a professionally made mouthguard that you wear during these types of activities and (2) that you also understand how this mouthguard protects you. Below are just a few ways.

1. Lacerations. A custom-fit, professionally made mouthguard covers the sharp surfaces of the teeth to protect the soft tissues of the cheeks, lips, gums and tongue from lacerations that can occur from a blow or sudden jolt.
2. Mouth Impact. Just as a mouthguard protects against soft tissue lacerations, it can also help prevent injuries to the jaws and teeth. This includes but is not limited to chipped teeth, fractured teeth, broken teeth and teeth that are partially or fully knocked out of their natural position.
3. TMJ (jaw joint) Trauma. Wearing a properly fitted mouthguard can reduce the potential for jaw displacement and joint fractures by cushioning the jaws against damage from an impact.
4. Direct Jaw Impact. Anytime a person receives a direct impact to his/her jaw, having a mouthguard in place may help prevent more serious injuries to teeth and jaws. This is especially important for anyone diagnosed with TMJ.
5. Jaw Fracture. A custom-fit, professionally made mouthguard both absorbs and distributes impact forces so that jaws are protected. And it is this reduction in force that can help prevent the jaws from fractures.
6. Under Chin Impact. Receiving a blow under the chin can obviously damage teeth; however, it can also cause damage to the jaws as well as inflame or cause TMJ issues.

You can learn more about mouthguards by continuing to read the Dear Doctor magazine article “Athletic Mouthguards.” Or you can contact us today to schedule an appointment.

Many youngsters look forward to finding a surprise under their pillow after a visit from the “tooth fairy.” This fable may comfort children who wonder why their first teeth come out. Parents need to know that losing baby teeth, also called primary or deciduous teeth, is completely normal, but at the right time and the right “space.”

A child's first set of teeth must be lost to create room for the adult or permanent teeth that have been forming beneath them. The buds of the permanent teeth grow within a child's jawbone just under the baby teeth. The tops, or crowns, grow first, followed by the roots. Then as the roots develop, the permanent teeth push the baby teeth above them up through the gum tissues. As this happens, the roots of the baby teeth are resorbed, or melted away.

With their roots gone, eventually the baby teeth become so loose that they can be easily removed or fall out on their own, making room for the adult teeth to appear. Sometimes, when a baby tooth is so loose, it can be wiggled out. It leaves a little bleeding gum tissue that heals easily. This is also normal.

Besides making sure the tooth fairy comes, parents need to be sure that their children are evaluated to determine whether baby teeth are being lost in the right sequence so they will act as guides for the adult teeth. If teeth are lost prematurely because of decay or trauma, it is important that space is maintained for the adult teeth when they come in.

Contact us today to schedule an appointment or to discuss whether your child's baby teeth are being lost in the right sequence and the adult teeth are coming in correctly. To read more about losing baby teeth, see the article “Losing a Baby Tooth: Understanding an important process in your child's development.”

Nearly every parent and caregiver has experienced that almost instantaneous sick feeling when they see that their child has been injured, especially when it is an injury to the mouth and teeth. For some, it is just a bloody lip; however, if the accident chipped a tooth, then you may have a completely different situation on your hands. If the nerve of the tooth has not been damaged, you needn't worry too much — a composite (plastic) tooth-colored restoration that is actually bonded to the tooth is an ideal material for repairing most broken or chipped teeth. See us as soon as possible to assess the extent of injury, so that proper and appropriate action can be taken.

An additional reason why bonding with composite resin may be the ideal choice for repairing a child's chipped tooth is that it can be custom created in virtually any shade so that it perfectly matches the damaged tooth and the surrounding teeth. It is also far less expensive than a crown, an important factor to consider when repairing a primary (baby) tooth that will eventually fall out to make room for a permanent tooth. If the injury is to a permanent tooth, a composite resin still may be ideal to use as a restoration until your child or teenager has stopped growing or playing contact sports. This is because your teenager may be too young for a more permanent restoration such as a crown or porcelain veneer.

An important, proactive step you can take to be prepared for the next time your child has a dental injury is to download Dear Doctor's Field-side Pocket Guide for Dental Injuries. This handy, quick reference guide is a must have for athletes, parents, caregivers, teachers, coaches or anyone who is often in an environment where a mouth injury is likely to occur. Knowing what to do and how quickly you must respond can make the critical difference between saving and losing a tooth.

In modern society, a bright, white smile conveys optimal health, youth and sound teeth. However, various influences including age, wear, diet, and lifestyle may prevent you from having and maintaining the glistening smile you long to share with the world. Luckily, there are many safe, inexpensive, and successful treatment options for discolored or stained teeth.

We can perform a “power bleaching” in our office to whiten teeth that are severely stained or discolored. This procedure whitens the external surfaces of the teeth by using a high concentration (35-45%) hydrogen peroxide solution, which is sometimes activated by a specialized light. To prevent irritation of the mouth's soft tissue lining during this procedure, we will isolate your gums and membranes with a rubber dam, a silicone or other effective barrier. Professionally applied in-office power bleaching provides control, speed, and predictability capable of lightening teeth up to ten shades in an hour. Don't try this at home! Our staff will take precautions in the office to avoid side effects and possible tooth sensitivity.

We can also provide you with custom-made, vacuum-formed, plastic bleaching trays for use with a take-home whitening application. In this instance, a gel made from carbamide peroxide (4-7% hydrogen peroxide, safe for home use) is delivered to the tooth surfaces in the bleaching trays. You will need to wear the tray for 30 minutes twice a day, which is a longer process than in-office bleaching. The first subjective signs of whitening will occur after three or four sessions, allowing whitening of up to eight shade units.

Another home-based option, whitening strips, essentially look like band-aids for the teeth. They are capable of lightening teeth by about three shades after being worn directly on the surface of the teeth for 30 minutes twice a day for one week.

If you have always wanted whiter teeth, schedule an appointment so we can determine which of these treatment options would work best for you. For more information on the fundamentals of teeth whitening, read the informative Dear Doctor magazine article “Teeth Whitening: Brighter, Lighter, Whiter...”

Recent research has revealed a relationship between overall general health and proper care for your dentures. The evidence shows that oral bacteria have been implicated in bacterial endocarditis (“endo” – inside; “card” – heart), chronic obstructive pulmonary (lung) disease, generalized infections of the respiratory tract and other systemic diseases. This proves what you might not suspect — you need to pay attention to the care of your dentures to achieve optimal health. For this reason, we have put together this list of five great tips for caring for your dentures.

1. Daily cleaning at home: It is critical that you thoroughly remove the bacterial biofilm in your mouth and on your dentures. This one tip alone will help minimize the likelihood of your developing inflammation (denture stomatitis) under your dentures.
2. Don't boil your dentures: While cleaning is important, you should NEVER place your dentures into boiling water because it can damage and warp them.
3. Don't wear your dentures 24/7: To help reduce or minimize denture stomatitis, you really should not wear your dentures 24/7. It is important to thoroughly clean them each night along with your mouth (as noted above), and then leave them out while you sleep. This will also slow down the bone loss that naturally occurs from the pressure caused by wearing dentures.
4. Always store your dentures immersed in water: This tip is so important because it helps prevent your dentures from warping. And do not forget to change the water each day, as well as to clean the container in which you store them.
5. Annual professional cleaning: Even though you may do an excellent job cleaning your teeth at home, you still need to come to our offices at least once a year for an examination, fit and function check, as well as a professional cleaning. During this cleaning, we will use our ultrasonic cleaners to minimize the biofilm that accumulates over time.

To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or you can contact us today to schedule an appointment to discuss your questions.

Did you know that studies have shown a relationship between gum disease and heart disease?

The common link is inflammation. This means that if you reduce inflammation caused by gum disease (periodontal disease), you also reduce your risk for heart attacks and strokes. The methods we stress for good dental hygiene — consistent effective brushing and flossing, regular professional cleanings by a hygienist, and dental treatment when needed — are also important for the maintenance of a healthy cardiovascular system (from cardio, meaning heart, and vascular, meaning blood vessels).

Here's how it works. Dental plaque is a film of bacteria that settles on your teeth near the gum line every day. When you brush and floss, you remove as much of this bacterial film, or biofilm, as you can. Bacteria that are not removed multiply and produce acid products that begin to dissolve the enamel of your teeth. They also irritate your gum tissues.

Your immune system tries to remove the bacteria and their byproducts through inflammation, your body's way of attacking substances that shouldn't be there (such as bacteria). However, long-term inflammation can be harmful to your own tissues as well. Inflammation in your gums, a symptom of periodontal disease, can destroy gum tissue, bone and the ligaments that hold your teeth in place.

Ongoing inflammation can also increase your risk for heart disease and stroke. Bacterial byproducts of periodontal inflammation have been shown to cause the liver to manufacture a protein called CRP (C-reactive protein) that spreads the inflammation to the arteries, where it promotes formation of blood clots.

Of course, other factors are also related to an increased incidence of cardiovascular disease. These include smoking, diabetes, obesity, high blood pressure, and physical inactivity. Family history and depression can also influence gum disease and heart disease.

Diet is another factor. You have probably heard of “good” cholesterol (HDL) and “bad” cholesterol (LDL). The bad one, low-density lipoprotein or LDL, is found in animal fats. It can cause an accumulation of fat breakdown products (also called plaque, but a different substance from dental plaque) inside your arteries. The arteries become narrow, so that they can be easily blocked, resulting in heart attacks and strokes. Studies have shown that inflammation of the lining of the blood vessels accelerates this effect.

If tests show that you have high levels of LDL, your doctor may advise you to modify your diet and take specific medication to reduce arterial plaque. You will also be advised to make lifestyle changes to reduce your risk factors. Lowering your weight, getting more exercise, and stopping smoking can have a positive effect on your heart health — and so can improving your dental hygiene to combat periodontal disease.

Contact us today to schedule an appointment to discuss your questions about the relationship between gum disease and heart disease. You can also learn more by reading the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.”

Model Christie Brinkley's smile has been a symbol of America's optimism since the seventies. Particularly well known for being the cover model for three consecutive Sports Illustrated Swimsuit editions, Brinkley still has a fresh-faced American girl-next-door beauty that starts with her cheerful smile, which transmits the message that all is well.

Brinkley's modeling career began when she was “discovered” in Paris in the seventies, at the age of 18. As she explained in an interview with Dear Doctor magazine, it was like a fairy tale. She had gone to study art in Paris, where a fashion designer spotted her walking down the street. “He told me later he immediately thought, ‘That's the girl!’” she said.

Brinkley attributes her famous smile to a combination of good genetics (she inherited her mother's “beautiful straight teeth”), combined with the intelligence to practice good oral hygiene and have regular dental appointments. She never needed to have work done to prepare her for the modeling life; but as a teenager, she said, she wished she could wear braces because she thought the “coolest kids had them.”

Although dental restorations were not needed to enhance her beautiful natural smile, she did have two dental implants after she fractured two rear molars in a bad helicopter crash while back-country skiing, and she says she is thankful for dental implant technology because it looks and feels so natural.

Brinkley said that her smile led directly to her assignment as spokesperson for a brand of oral rinse and mouthwash products. She is also concerned about the environment. Her company Christie, Inc. is designing environmentally friendly products.

Her advice to everyone is to smile more. “I think a smile makes EVERYONE beautiful! It's the greatest gift we give each other... It's an expression of friendship, love and peace!”

If you have questions about your smile, contact us today to schedule an appointment. Or you can learn more by reading the Dear Doctor magazine article “Christie Brinkley's Supermodel Smile.”

Fracturing back molars is an experience no one ever wants to have. But when a helicopter crashed during a back country ski trip, supermodel Christie Brinkley soon discovered that she had fractured two molars. Fortunately for Christie, her oral health was restored with two dental implants. As she said during an interview with Dear Doctor magazine, “I am grateful for the dental implant technology that feels and looks so natural.”

While Christie's dental implants replaced back teeth, we routinely use them to replace both back and the more visible front teeth. But best of all, we have demonstrated expertise at making dental implant crowns look real. This is where we meld science and artistry.

What drives the most natural and beautiful result is how the crown (the visible, white portion of a tooth) actually emerges through the gum tissues. We also match the adjacent teeth identically in color, appearance, shape and profile. But we can't take all the credit, as it takes an entire “behind-the-scenes” team to produce dazzling results. Choice of materials, the laboratory technician (the person who actually handcrafts the tooth), the expertise we use in placing a dental implant crown and the total quality of care we provide are the ingredients necessary for success.

Another critical factor required is ensuring there is enough bone volume and gum tissue to support an implant. Both of these must also be in the right position to anchor an implant. However, if you do not have adequate bone volume, you may be a candidate for a minor surgical procedure to increase your bone volume through bone grafting or other regenerative surgical techniques.

To learn more about dental implants, continue reading the Dear Doctor magazine article “Matching Teeth & Implants.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination, listen to your concerns, answer your questions and discuss treatment options. And if you want to read the entire feature article on Christie Brinkley, continue reading “The Secret Behind Christie Brinkley's Supermodel Smile.”

Protecting one's smile is important at any age. This is especially true for people who participate in contact sports or other activities where a trauma to the mouth can occur. While we all tend to believe that we are safe and that injuries “only happen to other people,” we could not be further from the truth. Take, for example, Jillian Michaels, an accomplished author, business mogul, wellness expert, trainer and star of The Biggest Loser. She learned this invaluable lesson after breaking her two front teeth as a child and having them repaired with crowns. As Jillian stated in her interview with Dear Doctor magazine, “Now, I generally wear a mouthguard if I am doing anything where my teeth have any chance of being knocked out.”

We feel obligated to educate our patients so that you can make informed decisions about your oral health. This is why we put together the following brief list of research findings.

Did you know?

• According to the American Dental Association, an athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard.
• The US Centers for Disease Control reports that sports-related dental injuries account for more than 600,000 visits to the emergency room each year.
• People who do not have a knocked-out tooth properly reserved or replanted may face a lifetime cost of $10,000 to $20,000 per tooth, according to the National Youth Sports Foundation for Safety.
• The Academy of General Dentistry estimates that mouthguards prevent more than 200,000 injuries each year.

If feel you and/or your children need a custom-fitted, professionally made mouthguard, contact us today to schedule an appointment. During your private consultation, we will conduct a thorough examination, listen to your concerns, and answer all of your questions as we discuss the best methods for protecting your investment — your own, or your children's, teeth.

To learn more about mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards, One of the most important parts of any uniform!” And to read the entire interview with Jillian Michaels, please see the article “Jillian Michaels — The Biggest Loser's health and wellness expert talks about her oral health, keeping fit and plans for the future.”

Christie Brinkley's world-famous smile has graced the covers of countless magazines for over 30 years. In fact, in her own words from an interview with Dear Doctor magazine, the supermodel said, “I think my smile was really my passport to success in the modeling industry.” And while most of her smile's appeal comes naturally, Christie does give it a boost with good oral hygiene, regular dental checkups and tooth whitening. As Christie says, “When it comes to teeth, keep it as natural as possible. Do not go overboard on whitening. You want your teeth to compliment your face…your friends should not be required to wear sunglasses when you smile!”

Aside from some potential minor side effects such as tooth sensitivity, whitening teeth through bleaching is a relatively inexpensive way to brighten your smile conservatively and successfully. There are three common methods, as described below:

• An external or vital approach where “vital” (living) teeth are bleached through direct contact to the tooth's surface.
• An internal or non-vital approach where the tooth is whitened from the inside during a root canal treatment.
• A combination approach in which both internal and external bleaching techniques are used.

But what causes teeth to become discolored?

Tooth discoloration can be caused by a traumatic blow to your teeth resulting in nerve tissue (pulp) death. However, there can be many other causes: consuming or using products that stain the teeth such as coffee, tea, cola, tobacco products and red wine, to name just a few. Aging is another factor, as it results in changes in the mineral structure of the tooth as the enamel, the outermost layer, loses its beautiful and youthful translucency. Other causes include exposure to high levels of fluoride; tetracycline, an antibiotic, administered during childhood; inherited developmental disorders and jaundice in childhood; and tooth decay.

The good news is that we routinely brighten smiles through tooth whitening. To learn more about brightening your smile, continue reading the Dear Doctor magazine article “Teeth Whitening.” Or if you are ready to have your teeth professionally whitened, contact us today to schedule an appointment so that we can conduct a thorough examination and discuss your whitening treatment options. And if you want to read the entire feature article on Christie Brinkley, continue reading “The Secret Behind Christie Brinkley's Supermodel Smile.”

How good of a job are you doing with brushing and flossing your teeth? This is an important question, because a healthy mouth depends on regularly removing dental plaque (a whitish, sticky film of bacteria that grows near your gumline and on the surfaces of your teeth).

Daily Plaque Removal
Most people need to brush and floss at least once a day to remove plaque. Twice a day may be ideal, as plaque forms every 12 to 24 hours on your teeth, and it will also make your mouth feel fresher. Be thorough but gentle with your teeth — excessive brushing or flossing can cause damage.

The use of an antibacterial mouthrinse to help reduce the plaque you may have missed as well as to reduce bacteria that are clinging to soft tissues or membranes in your mouth, should be included in your daily hygiene routine.

Tongue Test
When you run your tongue around your mouth after a professional dental cleaning, you sense a smooth, slippery feeling. This is the way your teeth should feel after you brush your own teeth every day. The tooth surfaces should feel smooth and slick throughout your mouth and at the gum line.

Floss Test
After running floss up and down a tooth surface, notice whether there is blood on the floss or whether the floss has an odor. If the floss squeaks when you run it up and down a tooth surface, that indicates that the tooth is squeaky clean.

Check for Bleeding
Bleeding gums are a sign of inflammation, called gingivitis, in the gum tissue. Healthy gums do not bleed. If you have recently begun using more effective brushing and flossing methods, your gums may bleed at first but then stop as your gums become healthier.

Use Disclosing Solutions
Disclosing solutions are harmless dyes that can stain plaque and make it visible. Rinsing with these solutions may surprise you by revealing the plaque on your teeth you had no idea you missed.

Visit Our Office
We can check your mouth and tell you how well you are doing in your program of daily plaque removal. As a bonus, we will give you a toothbrush so that while you're here we can check your technique to make sure you are brushing correctly.

Contact us today to schedule an appointment to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”

When it comes to sports, all athletes need to know how to assess their risk for experiencing a sports-related injury as well as how to prevent one. The first step to accomplish this is learning how sports and activities are classified, as they define risks from little-to-no chance of injury to highly susceptible for injuries. These categories include:

• Low velocity, non-contact sports: These sports and activities have the lowest risk, as they typically include sports where the athletes perform individually at reasonable speed without physical contact. Examples include: golf, Nordic skiing, weight lifting, running and swimming.
• High velocity, non-contact sports: These sports and activities are those where athletes move at high rates of speed but with no contact with other participants. While there is no contact, anytime you are moving at high rates of speed, accidents can happen. Examples include: bicycling, motocross, skateboarding, skiing and snowboarding.
• Contact sports: As the title states, these sports and activities include frequent body-to-body contact or body to equipment (e.g., a ball, glove, etc.) contact. Examples include: basketball, soccer, lacrosse, baseball and softball.
• Collision sports: With these sports and activities, strong, forceful, body-to-body or body-to-equipment contact is a primary goal of the sport. Examples include football, ice hockey, rugby, and boxing. Without the proper protective head and mouth gear, participants are highly likely to experience an oral-facial and/or head injury.

The good news is that you can dramatically reduce the odds of serious dental and oral-facial injury by ensuring that you wear a professionally made mouthguard in addition to a helmet, facemask, or other protective gear that is appropriate to the sport. This is especially true if you participate in the high velocity, contact and collision categories. These simple steps can help reduce worries for not only players, but also for parents, caregivers and coaches. For more information, read, “An Introduction To Sports Injuries & Dentistry.” You can also download a FREE, pocket-sized guide for managing dental injuries.