Elite Dental Studios

Chemotherapy and Oral Care

2012-02-01T07:30:00.000-08:00

You may be surprised that your dentist plays an important role in your cancer treatment. If you consult with your dentist before chemotherapy begins, you can help prevent serious mouth problems.
Chemotherapy is the use of specific drugs to treat cancer. These drugs kill cancer cells, but they may also harm normal cells, including cells in the mouth. Side effects include problems with your teeth and gums; the soft, moist lining of your mouth; and the glands that make saliva.
These drugs will basically diminish the immune response and therefor the patient becomes more susceptible to inflammation and/or infections. It is important to recognize and treat any oral pathology that may lead to an infection before the chemotherapy starts.
Also a loss in saliva will make the patient more vulnerable to tooth decay and gum disease. Saliva is a natural guard against plaque build up and bacteria. In it's absence oral bacteria tend to flourish which is why immaculate oral hygiene is essential during chemotherapy. A dentist can recommend ways to keep the oral environment moist.
If the oral side effects are severe, the patient may not be able to keep up with their cancer treatment which is why it is important to consult with a dentist before any chemotherapy.

Dental Resolutions

2012-01-03T08:20:00.000-08:00

Here are some dental resolutions for the new year that will keep you healthy and problem free:

1- Brush twice a day for about 2 minutes at a time. Not 1 minute, 30 seconds or once a day. It really does take that long to clean the majority of all surfaces of the teeth in your mouth decently.
2- Floss once a day. Approximately 40% of your teeth are not being cleaned if you don't do it and a substantial percentage of cavities start in those areas.
3- Clean your tongue. I would say 95% of patients don't do this. A couple of quick swipes on the tongue is usually enough.
4- Reduce your intake of sugary foods. it will decrease the incidence of cavities, improve your blood sugar and health.
5- Drink more water, especially after staining drinks like coffee, tea and wine.
6- Regular maintenance appointments at least every 6 months. Seeing your Dentist/Hygienist for a checkup and cleaning is truly the dental version of the oil change. Prevention is always the best option.
7- Get things taken care of while they are small and don't procrastinate. Fairly minor issues easily become more severe if neglected. Dentistry operates on an exponential cost scale as things get more involved and complex. Getting a restoration that costs a few hundred dollars (and is usually covered by insurance) is much better for you and your finances than letting it turn into a multi-thousand dollar root canal/post&core/crown or implant.

I hope this is helpful and happy 2012!

Dental Anxiety and Phobia

2011-12-05T12:14:00.000-08:00

Some people don't look forward to dental appointments but no more than they look forward to visits to other health care providers such as their physician. Most dental procedures when done right are reasonably comfortable. However, just being examined can make some people feel stressed. Most can live with having some anxiety about going to the dentist but for those with dental phobia, the thought of a dental visit is terrifying. They may be so frightened, in fact, that they'll do just about anything to avoid a dental appointment.

People often use the words "anxiety" and "phobia" to mean the same thing, but they are different. A phobia is an intense, unreasonable fear of a specific activity, object or situation. Phobic patients will have exaggerated or unfounded worries or fears. Dental phobia is definitely a more serious condition than dental anxiety. People with dental phobia often put off routine care for years or even decades. To avoid it, they'll put up with gum infections, pain, or even broken and unsightly teeth.

Dental anxiety and phobia are extremely common. It has been estimated that 9% to 15% of Americans avoid seeing the dentist because of anxiety and fear. That's about 30 million to 40 million people. In a survey 36% of those who didn't see a dentist regularly said that fear was the main reason.

People develop dental anxieties and phobias for many different reasons. When researchers interview patients, however, a few common themes emerge:
Pain and/or discomfort — In a survey of people who had not seen a dentist for 12 months, 6% reported fear of pain as the main reason. This may be because their early dental visits happened before many of the advances in "pain-free" dentistry.
Helplessness and loss of control — Many people develop phobias about situations — such as flying in an airplane — in which they feel they have no control. When they're in the dental chair, they have to stay still. They may feel they can't see what's going on or predict what's going to hurt. It's common for people to feel helpless and out of control, which may trigger anxiety.
Embarrassment — The mouth is an intimate part of the body. People may feel ashamed or embarrassed to have a stranger looking inside. This may be a particular problem if they're self-conscious about how their teeth look. Dental treatments also require physical closeness. During a treatment, the hygienist or dentist's face may be just a few inches away. This can make people anxious and uncomfortable.
Negative past experiences — Anyone who has had pain or discomfort during previous dental procedures is likely to be more anxious the next time around.

There are several relaxation techniques and tools that you can utilize to help you maintain your comfort during dental visits. Many patients prefer a distraction during their visit such as listening to an ipod filled with their favorite music. Relaxation breathing or progressive muscle relaxation are techniques you may wish to try prior to beginning.
Your dentist should always explain the procedure to you in detail and make sure that you fully understand the procedures being preformed. An educated patient will always make a better patient.
A signaling system is always useful if you feel you need a break. For most patients, being able to raise their hand and asking the dentist to stop is comforting and allows them to feel more in control of the situation.
Ultimately the most important part of overcoming dental fear is trust. Finding the right dentist who you are comfortable with and feel that you can trust will make the most difference in helping you relax during your visit.

Halloween & Healthy Teeth

2011-11-01T10:18:00.000-07:00

Undoubtedly, candy will come home in classroom party goody bags and fall festival take-home treats. Add plain old trick-or-treating, and it’s no wonder a child’s excessive exposure to sugar can be a common result. It’s definitely a problem every parent faces and finding that balance between children being healthy and at the same time having fun and enjoying Halloween is a tough balancing act.

The process by which sugary snacks can cause cavities is as follows. Bacteria that live in a child's mouth feed on sugars and produce acids. These acids will demineralize or break down the tooth structure, resulting in decay. Generally speaking the longer the exposure to sugary materials, the more extensive the decay. The frequency of sugar consumption is much more critical than the amount.

Prevention starts with that well-known word that is easy to say but more difficult to implement: moderation. However moderation can be difficult to enforce when a full Halloween bag lurks on top of the refrigerator. But protecting your children’s teeth from the onslaught of sugar is another important consideration for parents.
In the days following Halloween, it is recommended to ensure that your child eats a full plate of balanced and healthy foods before adding a sugary treat. Don’t buy Halloween candy too far in advance to avoid the temptation for children (and adults) to get a head start on the splurge. Try to ensure children eat a good, hearty meal before trick-or-treating so there will be less temptation to gorge on candy. Encourage kids to eat a set amount of candy in one sitting immediately followed by a thorough tooth-brushing, or at least a glass of water. Promote good oral health care habits year-round to your children by encouraging twice daily brushing with fluoridated toothpaste, flossing and getting regular dental checkups.

Gagging

2011-10-03T09:23:00.000-07:00

Gagging is a protective, natural reflex that stops entry of unwanted objects into the mouth and throat area. This reflex varies in intensity from one person to the next. Pronounced gag reflexes can compromise various aspects of dentistry, from diagnostic procedures of clinical examination and radiography to any form of treatment. In severe cases it could even lead to a patient avoiding care. There are many techniques in overcoming this condition and different strategies may be necessary in delivering dental treatment.

There are two basic classifications. One is called somatogenic which is induced by actual physical stimuli. The second is psychogenic in which psychological factors are thought to induce gagging without any physical stimulants.

Strategies for patient management fall under four categories.
First is psychological management via relaxation. This is accomplished through providing a comfortable and relaxing environment and/or breathing exercises like controlled rhythmic breathing and relaxed abdominal breathing.
Distraction techniques are also effective and thought to work by diverting attention away from the gagging problem long enough to carry out a procedure. Patients are asked to concentrate on a task or thought that will completely absorb their mind and prevent them from focusing on their gagging which increase their anxiety level.
Another technique is systematic desensitization and consists of incremental exposure to the feared stimulus which over a period of time will allow patients to become more used to certain stimuli.
Lastly there is the pharmacological option. A number of agents have been identified as effective against the gag reflex. Some topical anesthetics in forms of sprays or gels applied to the soft palate can be useful. Also some centrally acting drugs such as antihistamines and sedatives are helpful.

The attitude of the dentist toward the patient and his/her problem is ultimately very important. constant reassurance that the patient is alright will reduce embarrassment and anxiety.

Oral health & overall health

2011-09-06T14:50:00.000-07:00

In the past decade or so many researchers have come to realize that good oral health has very significant effects on the overall health of our bodies. It is extremely important to understand the intimate connection between oral health and overall health and what you can do to protect yourself.
Your mouth is normally teeming with bacteria — most of them harmless. The body's natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, harmful bacteria can sometimes grow out of control and cause oral infections, such as tooth decay and gum disease.
In addition, medical procedures, medications, or treatments that reduce saliva flow, disrupt the normal balance of bacteria in your mouth or breach the mouth's normal protective barriers may make it easier for bacteria to enter your bloodstream.

Your oral health may affect, be affected by or contribute to various diseases and conditions, including:

Endocarditis. Gum disease and dental procedures that cut your gums may allow bacteria to enter your bloodstream. If you have a weak immune system or a damaged heart valve, this can cause infection in other parts of the body — such as an infection of the inner lining of the heart.
Cardiovascular disease. Some research suggests that heart disease, clogged arteries and stroke may be linked to oral bacteria, possibly due to chronic inflammation from periodontitis — a severe form of gum disease.
Pregnancy and birth. Gum disease has been linked to premature birth and low birth weight.
Diabetes. Diabetes reduces the body's resistance to infection — putting the gums at risk. In addition, people who have inadequate blood sugar control may develop more-frequent and severe infections of the gums and the bone that holds teeth in place, and they may lose more teeth than do people who have good blood sugar control.
HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — may be associated with periodontal bone loss and tooth loss.
Alzheimer's disease. Tooth loss before age 35 may be a risk factor for Alzheimer's disease.
Other conditions. Other conditions that may be linked to oral health include Sjogren's syndrome — an immune system disorder — and eating disorders.

Be sure to tell your dentist if you're taking any medications or have had any changes in your overall health — especially if you've had any recent illnesses or you have a chronic condition.

Dental Sports Injuries

2011-08-01T08:06:00.000-07:00

According to recent research, dental injuries make up around 40% of the total number of sporting injuries that occur each year. It just goes to show how vulnerable our teeth can be, especially the front teeth. The added problem is that our vulnerable front teeth are also our most visible: so a lost tooth here can not only be painful, it can also be really damaging to our self-confidence and self-esteem.
The fact is that our teeth do not grow back and the risk of irreversible damage is real. So when you lose or damage a tooth due to a sporting injury, it is not quite the same as other injuries which heal over a period of time. While a damaged tooth may only feel like a minor injury, it is not and can in fact negatively affect other aspects of your oral and overall health. It can also mean that, in the longer term, you feel self-conscious about smiling, talking and eating in social situations.
It is important to realize that the aesthetics are not the only aspect of the damage that a missing tooth can cause. A missing tooth puts extra, unusual pressure on the remaining teeth and on your jaw, which can lead to a whole variety of aches and ailments, from grinding your teeth at night to having aches in the neck, shoulders, back and also damaging the remaining dentition.
Of course different severities of trauma and the specific circumstances will require different and yet appropriate treatments. The key is to contact your dental professional as soon as possible to have a clinical and radiographic examination and come up with a treatment plan.
Always use proper safety equipment, including a sports mouth guard when indicated as necessary.

Dental X-rays.

2011-07-06T09:23:00.000-07:00

Dental X-ray examinations provide valuable information that helps your dentist evaluate your oral health. With the help of radiographs a dentist can look at what is happening beneath the surface of teeth and gums.
As X-rays from an X-ray machine pass through your mouth they are mostly absorbed by teeth and bone because these tissues, which are called hard tissues, are denser than cheeks and gums, which are called soft tissues. When X-rays strike the film or a digital sensor, an image called a radiograph is created. Radiographs allow your dentist to see hidden abnormalities, like tooth decay, infections and signs of gum disease.
As far as frequency goes, we recommend a six-film series once a year and a full mouth series(18 films) once every five years. These guidelines provides optimal diagnostics over a patients life time and are considered very safe. In my practice we utilize digital X-ray systems that require even less radiation than conventional radiographs.
Finding and treating dental problems at an early stage can save time, money and unnecessary discomfort. Radiographs can help us detect problems in your mouth that otherwise would not be seen and are absolutely necessary.

Guide to different types of dental restoration

2011-06-02T12:17:00.000-07:00

Different types of dental restorations are designed to do specific jobs. Often the type of restoration recommended is directly dependent on how much healthy tooth structure is remaining after excavation of the pathology. Here is a breakdown of the most common restorations:

1. Sealants- White filling materials in a "flowable" form. Used to fill the decay-susceptible grooves of the back teeth. Usually utilized in children between 6-18 years as a preventative measure.
2. Fillings- Composite or white fillings. Placed directly into the prepared tooth. Used where the existing fillings or areas of decay are small enough that the remaining tooth structure has not been overly compromised.
3. Porcelain Inlays- Used in similar situations as fillings except a pre-made piece of ceramic material is bonded into the tooth. This results in superior physical properties, possibly providing a lifespan of 2 to 3 times longer than a composite filling. Inlays are a top-quality alternative to the composite filling.
4. Porcelain Onlays- Used in situations where the tooth is fractured or has been severely decayed, the onlay is similar to the inlay described above except that the ceramic covers the entire or most of the biting surface. An onlay is more conservative in preparation than a crown, it does not cover the entire visible tooth structure, so there is no need to grind away all sides of the tooth unless there is a specific reason.
5. Crowns(caps)- A crown, the largest single tooth restoration, sometimes cannot be avoided. It covers all sides of the tooth as well as the end. It is used when there is limited tooth structure left, when an existing crown must be replaced, or when the tooth is an "anchor" tooth for a fixed bridge.
6. Veneers- Thin porcelain facings that cover the front side of teeth. Used cosmetically to change the length, color and shape of teeth. Can be preformed with minimal tooth preparation and an excellent choice for a cosmetic make-over.
7. Bridges- Used to replace missing teeth when sufficient "anchor" teeth are available on each side of the gap. Numerous systems are available, including fiber-reinforced ceramics, Zirconium-based ceramics and porcelain fused to metal bridges.
8. Implants-Titanium posts surgically placed into the jawbone. After placement the bone grows around the implant through a process called osseointegration (usually three-six months after placement) and later the restorative phase can begin. Implants are used to support various dental prosthesis ranging from single crowns to a full denture. Given the choice between a bridge and an implant, an implant is considered the superior choice since it doesn't require preparation of adjacent teeth and there for more conservative.
9. Removable Partial Dentures- Used to replace missing teeth when insufficient teeth remain to support fixed bridges or a patient is not a good candidate for dental implants. Partial dentures can be metal or acrylic-based.
10. Removable Complete Denture- Utilized when no teeth remain and implants are not an option due to case specifics. By today's standards this is basically a last resort.

Mouth Ulcers

2011-05-09T11:37:00.000-07:00

Mouth ulcers, sometimes called canker sores, are a common affliction. Often they are simply caused by trauma and heal quickly on their own. The recurrent, bothersome form is known as recurrent aphthous stomatitis or simply aphthous ulcers. Certain triggers for these are stress, acidic foods, specific foods for the individual, trauma, chemical sensitivities, and can play a role in setting off an attack.
The cause of these ulcers is unknown, though it is believed to be some sort of immune mediated condition. At this time it seems aphthous stomatitis is not caused by any infectious agent (viruses or bacteria) and these ulcers are not contagious. Aphthae can also be manifestations of various systemic diseases such as Bechet's syndrome, HIV, autoimmune disorders, Crohn's disease, and the like.

There is no cure for aphthous stomatitis and lesions are basically treated palliatively. A dentist applied treatment, Debacterol, gives almost immediate relief and speeds healing. It is an acidic agent which chemically cauterizes the ulcer surface, sterilizing it, and covering the painful nerve endings. Only available as an in office treatment, Debacterol is 90 percent effective in giving immediate and lasting pain relief. Avoiding known triggers is helpful. A healthy diet with vitamin supplementation is recommended. Excellent oral hygiene, including use of antibacterial rinses (Rx chlorhexidine or OTC Listerine), has been shown to reduce frequency of attacks. Reducing stress is important as well. In severe cases a short course of systemic steroid (prednisone, etc.) may be needed. A new drug Apthasol is on the market and has been shown to have some beneficial effects as well.

Oral Hygiene

2011-04-04T10:08:00.000-07:00

Brushing and flossing your teeth are only parts of an optimal oral hygiene program. Most people know that good oral hygiene is important in maintaining the health of the teeth and gums, but it is also important to maintain the health of the entire mouth including other tissues in the oral cavity. In addition to brushing the teeth at least twice a day with fluoride toothpaste and flossing on a regular basis, it is also important to clean other areas of the mouth, particularly the tongue.
The tongue's rough and porous surface can harbor plaque-causing bacteria. Plaque is a bacterial film that forms when food particles collect on teeth, promoting tooth decay and gum disease. If the tongue isn't cleaned regularly and continues to harbor these bacteria, it can serve as a reservoir and re-seed the teeth and gums with bacteria.
Not only do the bacteria coating the tongue contribute to plaque formation, they also can cause odor, resulting in halitosis or bad breath.
The solution to these problems is brushing your tongue with a soft-bristled toothbrush in good condition at least a couple of times a week. An antiseptic mouthwash such as Listerine will also cut down on bacteria that dwell in the mouth.
An alternative to brushing the tongue is the use of a tongue scraper, which is a hand-held device, usually with serrated edges, designed to remove bacteria from the tongue by drawing them across its surface. Tongue scrapers are OK, but they're really no better than a good toothbrush. It's really up to the individual as to how they clean their tongue. The important thing is that they do it on a regular basis.

Food Allergies

2011-03-07T05:57:00.000-08:00

Food allergy occurs when the immune system mistakenly attacks a food protein as if it were a pathogen. Ingestion of the offending food may trigger the sudden release of chemicals, including histamine, resulting in symptoms of an allergic reaction. Scientists estimate that approximately 12 million Americans suffer from food allergies.
Food allergies can be diagnosed using a skin prick test or a blood test. A skin prick test is usually less expensive and can be done in the doctor’s office. A Positive skin prick tests or immunoassay test results will show that IgE antibody is present in the body, but cannot alone predict that a reaction will occur if the patient were to eat a suspected allergy-causing food. The results of the tests are combined with other information, such as a history of symptoms and the result of a food challenge to determine whether a food allergy exists.

Strict avoidance of the allergy-causing food is the only way to avoid a reaction. Reading ingredient labels for all foods is the key to avoiding a reaction. If a product doesn’t have a label, individuals with a food allergy should not eat that food. If you have any doubt whether a food is safe, call the manufacturer for more information. There is no cure for food allergies. Studies are inconclusive about whether food allergies can be prevented.
Symptoms may include one or more of the following: a tingling sensation in the mouth, swelling of the tongue and the throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, loss of consciousness, and even death. Symptoms typically appear within minutes to two hours after the person has eaten the food to which he or she is allergic.
Studies are inconclusive about whether food allergies can be prevented. Parents should become familiar with the early signs of allergic disease such as eczema, hives, repeated diarrhea and/or vomiting in reaction to formulas, wheezing, and talk to a doctor about those symptoms.
At this time, no medication can be taken to prevent food allergies. Strict avoidance of the allergy-causing food is the only way to prevent a reaction. Epinephrine, also called adrenaline, is the medication of choice for controlling a severe reaction. It is available by prescription as a self-injectable device (EpiPen® or Twinject®).

Nutrition Tips for Healthier Teeth and Gums.

2011-03-01T13:52:00.000-08:00

The types of foods you eat can affect your smile as much as brushing or flossing. Every time you eat sugary or starchy foods, the bacteria in plaque get another chance to form decay-causing acid. But choosing foods that naturally fight bacteria, remove plaque, strengthen enamel, and freshen breath is a good way to preserve your teeth.
1. Celery
Celery protects your teeth in two ways. The extra chewing it requires produces plenty of saliva, which neutralizes the bacteria Streptococcus Mutans that causes cavities. Additionally, chomping on naturally abrasive foods massages gums and cleans between teeth.
2. Cheese
Studies from the last decade show that cheese, with its low carbohydrate and high calcium and phosphate content, provides several benefits for your teeth. It helps balance your mouth's pH (an acidic pH encourages the growth of cavity-causing bacteria). Cheese also preserves and rebuilds tooth enamel and produces saliva, which kills the bacteria that cause cavities and gum disease.
3. Green Tea
Green tea contains substances called Catechins that kill the bacteria in your mouth that turn sugar into plaque. Catechins also wipe out the bacteria that cause bad breath.
4. Kiwis
For their size, kiwis pack more vitamin C than any other fruit. In fact, one large kiwi supplies more than 100 percent of your recommended daily amount. If you don't get enough vitamin C, research shows that the collagen network in your gums can break down, making your gums tender and more susceptible to the bacteria that cause periodontal disease.
5. Onions
Onions contain powerful antibacterial sulfur compounds. In a 1997 test tube study, onions killed various types of bacteria, including S. Mutans. Research indicates that they are most powerful when eaten freshly peeled and raw. Of course, raw onions can do a number on your breath, so be sure to have some fresh parsley on hand.
6. Parsley
Chewing parsley or mint leaves after a pungent meal will help you maintain sweet-smelling breath. These herbs contain Monoterpenes, volatile substances that travel quickly from your bloodstream to your lungs, where their odor is released via your breath.
7. Sesame Seeds
According to fossils, our Paleolithic ancestors had great teeth. Anthropologists suggest that this is partly due to the cleansing action of primitive foods like seeds, which slough off plaque and help build tooth enamel. Sesame seeds, for example, are also high in calcium, which helps preserve the bone around your teeth and gums.
8. Shiitake Mushrooms
A 2000 study in Caries Research showed that lentinan, a sugar found in shiitake mushrooms, prevents mouth bacteria from creating plaque.
9. Wasabi
Otherwise known as Japanese horse-radish, this condiment not only provides zing to sushi, it also protects your teeth. A 2000 study in Biofactors revealed that the substances that make wasabi taste hot, called Isothiocyanates, also inhibit the growth of cavity-causing bacteria.
10. water
Drinking water keeps your gums hydrated and is the best way to stimulate saliva--your body's greatest defense against the bacteria that cause plaque and cavities. Rinsing your mouth with water also helps wash away trapped food particles that decompose in the mouth and cause bad breath.

Bad Oral Habits

2011-02-14T13:47:00.000-08:00

While it is obvious that our teeth's main purpose is the initial processing of foods before swallowing, it is sometimes not so clear what other functions should be expected! As capable as our teeth are in biting and chewing food, there exists many limitations outside of this realm.
In all my years of clinical experience, I've come across lots of pathologies that are self-inflicted through misuse of teeth. As a general rule, I always tell my patients that when in doubt don't do it. It is easy to forget sometimes that our teeth can be quite fragile under certain circumstances and misuse could cause chips and fractures, resulting in unnecessary dental work. Here is a short list of some common things to avoid; Chewing ice, chewing non-food objects such as finger nails and pens, chewing some hard nuts either with or without shells, cutting strings and aggressive use of toothpicks, just to name a few.
We also recommend night guards to those who have a tendency to clench and/or grind their teeth. They are a small investment to make that can go a long way in preventing reversible or irreversible damage.
Lastly, please remember that it is not that we do not want to see you in the dental office. We just do not want to have to treat you in preventable situations! Please try to avoid using your teeth as a multi-purpose tool, unless of course it is for processing food!

Good Nutrition

2011-01-04T07:18:00.000-08:00

Good nutrition and healthy eating habits are essential to maintaining optimal oral and overall health. The food and beverage choices you make have a direct effect on the health of your entire body. Each time a sugary snack or beverage is consumed, the sugar, along with the bacteria in your mouth, bathe your teeth in harmful acids that attack your teeth for at least twenty minutes. Each bite or sip brings on another acid attack. After repeat attacks, teeth are susceptible to tooth decay.
While it’s important to eat a variety of nutritious foods from the five major food groups grains, dairy, fruits, vegetables and meat/poultry/fish, it’s not necessary to throw out everything in your pantry that contains sugar. Almost all foods, including milk and vegetables, contain some form of sugar, and many offer key nutrients that are part of a well-balanced diet. Instead of cutting out sugar from your diet altogether, one should read the labels on foods and beverages and set a goal to reduce those that contain added sugars, such as soft drinks, candy and cookies. Soda, whether regular soda containing sugar or diet sugar-free soda, is high in acid content and contributes to the erosion of enamel. The enamel layer which covers the outer surface of teeth is the hardest substance in the body and normally protects the inside of the tooth by acting as a barricade.
Also we should be limiting snacking between meals. Foods eaten as part of a meal cause less harm to your teeth because more saliva is released during mealtime. Saliva naturally protects our teeth and helps to wash food particles from your mouth, lessening the acid build up that leads to tooth decay.
When you need a snack, make nutritious choices, such as fruit, raw vegetables, cheese, plain yogurt or other snacks that are low in sugar. Instead of soda, choose healthy beverages, such as water or milk.
Brush twice a day with fluoride toothpaste. Floss daily to help remove plaque, the sticky film of bacteria, which gets stuck between your teeth and gums.
Schedule regular checkups with your dentist at least every six months to help prevent problems from occurring and detect possible problems in their early stages.

Diabetes and Oral Health

2010-12-08T07:17:00.000-08:00

Everyone is at risk of developing periodontal disease, but all people with diabetes, regardless of age or type of diabetes, are more susceptible. There are several reasons for this.
For one, people with diabetes can have more sugar in the mouth which provides a more hospitable environment for hostile bacteria. This makes all forms of periodontal disease and tooth decay more likely.
High and fluctuating blood sugar levels are also a factor in the increased risk of periodontitis and more vulnerability to complications. Patients with diabetes may also experience dry mouth as a result of reduced saliva. Neuropathy and certain medications may be the cause of reduced salivary flow which is a natural protectant against oral disease. Healing is also more difficult once an infection sets in. Just like diabetics with poor control have a hard time healing wounds and infections on their feet, their bodies have a hard time fighting infections and healing wounds in the mouth.
If and once an infection takes root a vicious cycle ensues making metabolic and infection control a struggle. This cycle can have drastic consequences. If oral infections get out of control they can lead to problems serious enough to land a person with diabetes in the hospital, to say nothing of the damage to the teeth and gums. Infections can also impact Insulin needs. Authors of a study cited in September's 1997's Practical Diabetology concluded that when an infection is rampant, patients with diabetes often have increased insulin requirements. If periodontal disease is treated and gingival inflammation is eliminated, these insulin needs often decrease. Collagen, which is a building block of the tissue that attaches teeth to bones and the surrounding soft tissue, is also affected by diabetes which make an infection potentially more destructive.
In conclusion diabetics have an increased risk of dental problems and for this reason not only should they keep their diabetes under control with a healthy diet and meds if needed, they also need to be especially vigilant with their hygiene and visit the dentist on a regular basis.

Veneers

2010-11-23T09:05:00.000-08:00

If you are looking to improve your smile, custom-fitted veneers can provide the answer. Veneers are thin, custom-made moldings that cover the fronts of unsightly teeth. They are crafted from tooth-colored, high-tech materials to portray a natural, bright smile. Veneers provide a safe and less invasive alternative to traditional crowns and unlike most bonding materials, they will not change color or wear over time. Veneers cover unattractive gaps, and can mask stained, misshaped or crooked teeth and are intended to last for many years.

Initially the tooth is minimally reshaped to allow for the added thickness and proper contour of the veneer. An impression is made of the reshaped tooth and sent to a dental laboratory where the veneer is custom-made to fit your mouth. The veneer is applied with adhesive material which bonds it to the original tooth structure and essentially becomes one with the tooth. Since veneers are individually sculpted for each patient, it is nearly impossible to tell the difference between a veneer and a natural tooth. They resist stains and wear because they are made of high-tech, extremely strong and polishable materials.

Veneers generally cannot be damaged by abrasion from your toothbrush or floss. Good oral hygiene will ensure your veneers stay strong and provide you with a long-lasting, attractive smile.

Dental Care During the Holiday Season.

2010-11-01T09:43:00.000-07:00

The holidays can be rough on daily dental and oral care habits. Frequent parties and snacking can constantly expose teeth to sugar and cavity-causing bacterial acids. Travels and overnight stays can disrupt daily brushing and flossing regimens. However, just because the holidays are here does not mean that one should give up on proper oral hygiene. With some preparedness, the festivities of the holidays can still be enjoyed without neglecting one's gums and teeth. Here are some important tips for a realistic dental care plan during the holiday season:

Don't leave home without it. Whenever traveling to a friend or family's home, don't forget to pack a spare toothbrush, toothpaste, and some floss. Make sure to pack enough dental supplies should the meal extend into an overnight stay or even longer.
Don't delay brushing/flossing. When festivities carry on for many hours and include multiple courses, it is easy to put off or neglect one's dental care. However, once the main course is finished and dessert has been served, it is a good time to excuse oneself to brush and floss. Even if the evening continues with drinks, the excessive sugars and acids that can damage teeth have been mostly cleared out of the mouth.
Don't over-indulge in sweet cocktails and food. Not only can excessive sugars cause weight gain and other unhealthy affects, but they can also result in tooth decay. try to make healthier choices and remember moderation is the key!
Don't forget about emergency dental contacts. Many dental offices close over the holidays. Be sure to ask your dentist when he is planning on taking a vacation and obtain some emergency dental contact phone numbers. One can never predict just when an emergency may occur.
If you know that you need some treatment, don't put off dental work until after the holidays. Doing so will probably make current dental issues worse. Likewise, it may lead to unnecessary toothaches during the time when one is supposed to be relaxing and having fun. Even if there are only a few days left until the big winter break, it is wise to take care of business first, so that there are no painful episodes later.

By following my advise, you will not be neglecting vital oral care during the holiday season. After all, smiling for photos, and tasting different holiday foods, would be difficult without healthy teeth and gums!

Happy Holidays!

Eating disorders

2010-10-12T06:54:00.000-07:00

It has been estimated that more than 10 million Americans currently are affected by serious eating disorders such as anorexia, bulimia and binge eating. While anyone can suffer from an eating disorder, they are most common in teen and young adult women. Eating disorders can have a large negative impact on an individual’s quality of life.

Three different types:

Anorexia typically involves an extreme fear of gaining weight or a dread of becoming fat. Even though these individuals may be very thin or even extremely underweight, they see themselves as “fat.” They may attempt to reach or maintain what they think is their perfect body weight by literally starving themselves. They may also exercise excessively.
Bulimia also includes the fears of being overweight. But it also includes hidden periods of overeating (binge eating) which may occur several times a week or even several times a day. After they overeat, the individuals try to “undo” the fact that they ate too much as quickly as possible by forcing themselves to “throw up” or by the misuse of laxatives or enemas.
Binge Eating or Compulsive Overeating may affect almost as many men as women. In the past, these individuals were sometimes described as “food addicts.” They overeat (binge eat) as noted in bulimia above, but do not regularly try to get rid of the food immediately by throwing up or by misusing laxatives or enemas.

General symptoms:

Each of these eating disorders can rob the body of adequate minerals, vitamins, proteins and other nutrients needed for good health. Individuals with eating disorders can display a number of symptoms including dramatic loss of weight, secretive eating patterns, hair loss, feeling cold, constipation and, for women, the loss of their monthly menstrual period. Eating disorders may also cause numerous other physical health complications, such as heart conditions or kidney failure, which can lead to death.
Eating disorders can also affect oral health. Without the proper nutrition, gums and other soft tissue inside your mouth may bleed easily. The glands that produce saliva may swell. Individuals may experience chronic dry mouth. Throwing up frequently can affect teeth, too. When strong stomach acid repeatedly flows over teeth, the tooth’s outer covering (enamel) can be lost to the point that the teeth change in color, shape and length. The edges of teeth become thin and break off easily. Eating hot or cold food or drink may become uncomfortable.

Prevention and awareness:

Eating disorders arise from a variety of physical, emotional and social issues all of which need to be addressed to help prevent and treat these disorders. Family and friends can help by setting good examples about eating and offering positive comments about healthy eating practices. While eating disorders appear to focus on body image, food and weight, they are often related to many other issues. Referral to health professionals and encouragement to seek treatment is critical as early diagnosis and intervention greatly improve the opportunities for recovery.

Treatment of Oral Health Consequences of Eating Disorders

Maintain meticulous oral health care related to toothbrushing and flossing.
Immediately after throwing up, do NOT brush but rinse with baking soda to help neutralize the effects of the stomach acid.
Consult with your dentist about your specific treatment needs.
See your dentist regularly.

How does toothpaste work?

2010-10-11T07:20:00.000-07:00

It is a well established belief that brushing daily strengthens our teeth and makes them healthier. Most of us do this on a daily basis without even wondering how it actually works. One should know not only the mechanism of action of a toothpaste but also the role of individual ingredients which will help in choosing an effective brand. There are three basic mechanisms by which a toothpaste improves the health of our teeth and these are as follows:
• Abrasive Action: The abrasive agent in the toothpaste physically removes the solid particles stuck on tooth surfaces and in the oral cavity by abrasive action. It also helps in removing food stains and polishing tooth surface which in turn will improve the tooth's self cleaning contours and limit plaque build up.
• Antiseptic Action: The toothpaste contains antimicrobial agents such as Xylitol which inhibit the growth of bacteria in the mouth which is especially helpful in gum disease.
• Action of fluoride: Fluoride is an important aspect of a toothpaste and in various forms is the most popular active ingredient to prevent cavities. Although it occurs in small amounts in plants, animals, and some natural water sources, and has effects on the formation of dental enamel and bones, it is not considered to be a dietary essential and no deficiency signs are known. Sodium fluoride (NaF) is the most common form. It replaces the hydroxypatite of tooth with fluoropatite which is not only much stronger but also resistant to caries. It has been shown that topical fluoride can actually remineralize damaged Enamel and essentially reverse the process by which cavities form!

Understanding Gum Disease

2010-10-07T07:21:00.000-07:00

Generally speaking there are two categories of gum disease; Gingivitis (gum inflammation) usually precedes Periodontitis (gum disease and bone loss). However, it is important to know that not all Gingivitis progresses to Periodontitis.
In the early stage of Gingivitis, bacteria in plaque build up, causes the gums to become inflamed (red and swollen) and often easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.
When Gingivitis is left untreated, it can advance to Periodontitis. In a person with Periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected and lead to loss of attachment (bone loss). The body's immune system fights the bacteria as the plaque spreads and grows below the gum line.
Toxins or poisons - produced by the bacteria in plaque as well as the body's "good" enzymes involved in fighting infections - start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose and tooth loss occurs. Gum disease, in fact, is the leading cause of tooth loss in adults.
What is important clinically is to diagnose and treat gum disease before it progresses. At Elite Dental Studios we have the resources and expertise to diagnose, treat and maintain gum disease regardless of it's severity. As a general rule, the sooner the treatment, the better the outcome!

Root Canal Therapy

2010-09-13T10:27:00.000-07:00

We pride ourselves in spending the time to properly educate our patients on the details of proposed treatment. I have often said that the better informed the patient is, the better the overall dental experience will become. Having said this, I would like to explain one of the most misunderstood procedures in dentistry, the root canal. It is needless to say that root canal treatment has a bad reputation! Perhaps because of the pain and discomfort of a damaged nerve that necessitated the root canal procedure in the first place. However the actual treatment is relatively painless because the pain can be controlled with a local anaesthetic during the procedure and pain control medication can be used before and/or after treatment. Modern root canal treatment is completely safe and usually very predictable.
Due to recurrent decay and/or some form of trauma the nerve inside the tooth can become damaged and inflamed. This inflammation is of two varieties; reversible pulpitis or irreversible pulpitis. The former will pass by itself after final restoration but the latter will require further treatment. Irreversible pulpitis usually leads to necrosis or the nerve dying which in turn, if untreated, will lead to infection of the jaw bone. Root canal treatment is the actual removal of the necrotic nerve and filling of the tiny canals in the root of the tooth where the nerve runs. We always utilize a certified Endodontist when such treatment is necessary to ensue the best outcome for our valued patients.
Lastly, it is very important to properly restore the tooth that has had root canal therapy in a timely manner to ensure continued success. this will usually require a post and a crown.

Healthy alternatives in dental materials

2010-08-04T08:58:00.000-07:00

There are numerous types of materials being used in dentistry today and some are more non-reactive in the body than others. Many people are sensitive/allergic to metallic restorative materials such as the dental amalgam. The dental amalgam contains mercury and other metals that may be toxic to the body. People who have amalgams replaced by other materials such as porcelain or composite resin actually report that they feel healthier than before. Dental amalgams are still considered safe in the US although are being used less and less. In some European countries, they are seldom or no longer placed. Personally, I have not used any amalgam for a decade or so and I find that the alternatives are not only safer but also better from a restorative point of view.

Oral Hygiene and Cardiovascular Disease

2010-07-08T12:45:00.000-07:00

A recent study in the British Medical Journal has suggested that people who don’t brush their teeth twice daily are more susceptible to having heart disease in the future. In the past, most researches were concerned with the role of oral and gingival inflammation in building up atherosclerosis; in fact, this is the first study to examine if the number of teeth brushing has an impact on developing CV diseases, or not. The data was collected from Scottish Health Survey, which was performed on all adult participants . Results have revealed that participants who brushed their teeth less frequently had higher risks of heart disease than individuals who reported teeth brushing twice daily. Scientists believe that bad oral hygiene increases the risk for heart diseases through flaring systemic inflammation. Usually, the increased inflammation is associated with generalized homeostatic responses, besides; periodontal infection is proved to cause the disturbance of lipid metabolism, which will eventually cause most types of cardiovascular disease.
Bottom line is that there is absolutely no substitute for proper oral hygiene . Brushing and flossing your teeth twice daily has numerous benefits that extend well beyond the mouth!

Multidisciplinary Team

2010-06-01T12:08:00.000-07:00

Many years ago a primary dentist was a jack-of-all-trades when it came to different arenas of dentistry. A dentist would fill your cavities, pull your wisdom teeth, preform Root Canal Treatments if necessary and manage your gums. This approach worked at the time mainly because the level of sophistication in diagnosing and treating dental conditions was relatively low. However in this day and age there have been such amazing advances in all categories of dentistry, that the old one-size-fits-all approach is no longer the best option clinically for the patient. A more comprehensive approach, by today's standards, is referred to as a multidisciplinary approach where a group of providers specializing in different areas, collaborate in treating a patient. The primary dentist or in my case a Prosthodontist would initiate the treatment and make the appropriate referrals when necessary. This allows the patient to receive the best and most advanced care no matter what the necessary treatment is. We have been practicing this approach for many years at Elite Dental Studios, utilizing the very best resources available to provide the absolutely best dental care possible for our patients!

Self Image

2010-05-11T09:56:00.000-07:00

In my experience, how people take care of their mouths is often a reflection of how they feel about themselves. Those who feel good about themselves take good oral care and people who have a poor self image generally do not take good care of their mouth. It has also been shown that this works in reverse meaning that addressing one's dental health/aesthetics will usually lead to a better quality of life and self image! This holds especially true for cosmetic procedures. Often I am witness to a patient's general well being and attitude improving substantially after cosmetic treatments such as whitening and/or porcelain veneers. This in turn is extremely rewarding to myself and my staff and creates a deep appreciation for what we do!

Cosmetic Dentistry

2010-04-27T09:06:00.000-07:00

Are you dissatisfied with the appearance of your smile? Does the color, shape and/or position of your teeth embarrass you? Do you ever smile with your mouth closed or cover your teeth with your hand? If you answered yes to any of these questions you are a candidate for cosmetic dentistry. In fact, anyone who is unhappy with the appearance of their smile is a good candidate for cosmetic dentistry. Today’s advanced cosmetic procedures have truly come a long way and can transform any smile into the smile you’ve always dreamed of. Cosmetic dentistry covers a multitude of safe and proven methods from smile whitening to repairing, straightening or replacing teeth. A well qualified cosmetic dentist should be able to carry out a comprehensive smile analysis in addition to periodic examinations, to come up with the plan that best suits you. Even the most unsightly smiles can be improved and usually relatively easily as well. Many procedures can be completed in one to three simple visits. Many people are simply amazed to discover the difference cosmetic dentistry can make in their appearance and self-confidence.

Botox

2010-03-25T10:49:00.000-07:00

Most people do not associate Botox treatments under a dental setting, but this is about to change.
More and more dentists are becoming trained in Botox application and as it turns out, it is a perfect match for the profession. Very few health care professionals have as much intimate knowledge of the anatomy and function of the musculature and neural pathways of the head and neck. Also dentists as a whole are absolutely proficient in giving injections on a daily, almost hourly basis.
Botox is a purified protein derived from an organic compound, much like penicillin is and thus very safe to use. It is a temporary muscle relaxant that is injected locally into specific muscles of the head and neck. Botox injections have numerous potential purposes in a dental practice. One being treatment of TMJ type pain/migraine headaches. Another purpose is controlling the tone of muscles of mastication(jaw movement) in order to increase the success rate of other dental treatments such as implant restoration and restorative treatments in general. The last purpose is what the majority of the population associate Botox with, that is cosmetics. Botox is the perfect compliment to cosmetic dentistry and overall improvement of facial aesthetics.

Halitosis

2010-03-16T13:49:00.000-07:00

Bad breath, medically termed as Halitosis is a condition that produces unpleasant feeling due to a foul smell coming from the mouth. The most common cause is poor oral hygiene which will lead to tooth decay and/or gum disease. Biologically speaking, the bad odor is a result of Volatile sulfur compounds released, which have a typical rotten-egg smell.

To fight bad breath one should maintain proper oral hygiene - Use fluoride toothpaste, and brush and floss your teeth twice daily. After every meal you have to rinse your mouth thoroughly with water. Teeth should be cleaned professionally - Visit your dentist regularly, at least once every 6 months so that any decay and/or gum disease can be diagnosed and treated in a timely manner. Modify your diet - Sometimes changes in the diet timings and the food you eat, can improve things. Maintain a mixed diet of all foods, including carbohydrates, proteins, fats along with fruits and vegetables. Chewing certain herbs like coriander, spearmint, eucalyptus, and cardamom can also help. Try to quit habits like smoking, chewing tobacco and excessive alcohol consumption. Foods like berries, melons and any citrus fruits are rich in vitamin C, and help in locking the growth of bacteria, thus gum disease and periodontal pocket formation are controlled. Use a tongue cleaner, to always keep the surface of the tongue clean.

Halitosis can sometimes be a sign for a medical condition. Most commonly, respiratory tract infection like infected throat, lung infections, sinus tract infections, and other systemic illnesses like diabetes, chronic bronchitis, liver or kidney disorders. If your dentist indicates your oral hygiene as good and no dental pathologies present, then you should visit a physician to determine the cause.

Dry Mouth

2010-03-03T11:27:00.000-08:00

Dry mouth is a decreased flow of saliva that may be associated with dehydration, radiation therapy of the salivary gland regions, anxiety, the use of drugs (such as atropine and antihistamines), vitamin deficiency, various forms of parotitis, or various syndromes (such as Plummer-Vinson syndrome). Dry mouth is a significant health problem because it can affect nutrition and psychological well-being, while also contributing to tooth decay and other mouth infections.
To minimize such risks one should brush teeth and use dental floss at least twice a day. Use a toothpaste that contains fluoride. Ask your dentist about using a topical fluoride. Avoid sticky, sugary foods or brush immediately after eating them. See your dentist at least three times a year for cleanings and early treatment of cavities. Ask your dentist if you should use a remineralizing solution or prescription-strength fluoride. Take frequent sips of water or drinks without sugar. Pause often while speaking to sip some liquid. Avoid coffee, tea and soft drinks. Drink frequently while eating. This will make chewing and swallowing easier and may increase the taste of foods. Keep a glass of water by your bed for dryness during the night or upon awakening. Chew sugarless gum - the chewing may produce more saliva. Eat sugarless mints or hard sugarless candy but let them dissolve in your mouth. Avoid tobacco and alcohol. Avoid spicy, salty and highly acidic foods that may irritate the mouth. Ask your dentist about using artificial salivas to help lubricate the mouth. Use a humidifier, particularly at night.

Occlusion

2010-02-11T11:48:00.000-08:00

Occlusion is the relationship between top and bottom teeth or the 'bite'. This relationship is of the utmost importance in many aspects of dental treatment and often overlooked with less than optimal results. Everyone has a different type of occlusion which is quite specific to that individual and considered optimal for that person. However, regardless of the type, it is extremely important to always take this patient-specific pattern into consideration when planning and preforming dental treatments. Occlusion effects many different aspects of dental health and ignoring occlusal patterns will more often than not reduce the probability of success. Personally, my staff and I will always spend the extra time to evaluate and equillibrate our patients' occlusions at, as many different intervals as necessary, during a comprehensive treatment schedule to ensure the best end results in our approach.

Fluoride

2009-11-24T08:42:00.000-08:00

Everyone knows that fluoride is good for your teeth, however few people realize that there are actually two different mechanisms by which Fluoride can be introduced to tooth structure. First is a systemic introduction through ingestion which occurs inside the jaw and before exposure to the oral cavity. Second is a topical application to teeth that have already erupted.
The actual mechanism of fluoride action is still a subject of debate. A dogma has existed for many decades, that fluoride has to be ingested and acts mainly pre-eruptively. However, recent studies concerning the systemic effect of fluoride supplementation concluded that the caries-preventive effect of fluoride is almost exclusively posteruptive. Moreover, epidemiologists have cast doubt on the validity of the 'old' studies dealing with fluoride use. The concept of the posteruptive fluoride effect is supported by in vitro and in situ investigations demonstrating that the mode of action of fluoride can be attributed mainly to its influence on de- and remineralization of dental hard tissues. Therefore, topical fluoride application in the form of fluoridated dentifrices(tooth paste or mouthwash) should be encouraged.

Bruxism/TMD

2009-11-09T08:49:00.000-08:00

Bruxism put simply is the conscious or subconscious grinding and/or clenching of teeth. Most people have heard of the abbreviation; TMJ, this stands for Temporomandibular joint which are the jaw joints directly in front of the ears. TMD is any dysfunction that is associated with the TMJ.
There are various severities of TMD, ranging from slight pressure or discomfort to very severe pain and dysfunction. The etiology or cause of TMD is usually some form of occlusal discrepency or unbalanced bite. When the teeth don't line up and come together evenly, our bodies natural and often subconscious rection is to clench or grind in certain spots. This in turn will lead to problems with the jaw joints or some form of TMD. Bruxism is often cyclical( comes and goes) and progressive( tends to worsen with time). The good news is that for most people there is an easy fix in the form of an occlusal appliance or custom fitted hard night guard.

Prosthodontist.

2009-09-29T08:32:00.000-07:00

As most of my patients and colleagues know, in addition to a family practitioner I am also a Prosthodontist. I received a DDS from Columbia University School of Dental Medicine, a General Practice Residency Certificate from Montefiore Medical Center and a Prosthodontics Certificate from New York University.
In this entry I will attempt to explain what a Prosthodontist is. The American Dental Association(ADA) recognizes a handful of specialties in the practice of dentistry. The ADA's definition is as follows; Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. In simpler terms a Prosthodontist has additional training in various techniques and procedures in restoring and/or replacing teeth.
It is a unique specialty in the sense that is relatively diverse as compared to other specialties. A Prosthodontist has a distinct advantage of not only being the primary restorative dentist, but also having a unique insight into all other specialties, allowing him/her to better coordinate a multi-disciplinary team of specialists.
Prosthodontics allows the capability and expertise to handle many different treatments from a simple procedure such as an onlay to a rather complex one such as a full mouth rehabilitation or cosmetic make over.

The true value of teeth.

2009-09-23T08:22:00.000-07:00

Time and time again I see new patients who are dissatisfied with work that was done previously. More often than not, the condition is irreversible and more complex treatment is necessary to rectify the situation.
As adults we all have approximately 32 teeth and there are no spares. Once a tooth is damaged or lost it is not coming back. This is the reason why every single tooth is so valuable and irreplaceable.
In my opinion the key to better dental care is proper diagnosis and treatment in the first place. Too many people assume that a dentist is a dentist and that you get the same caliber of dentistry no matter where you go. Unfortunately this is far from the truth. Even more unfortunate is that by the time a patient realizes that previous treatments were faulty, it is often too late.
My staff and I have many years of training and experience and pride ourselves in providing the most conservative and clinically sound treatment bar none. There is absolutely no substitute to doing it right in the first place!

Dental care in a down economy.

2009-08-25T09:02:00.000-07:00

Before I start, I would like to recognize that some of the materials that are mentioned may seem repetitive. This is due to the fact that various tips and recommendations are relevant to different topics and circumstances. One such recommendation is a minimally invasive approach to oral health in conjunction with a preventative and comprehensive philosophy.
In a down economy the last thing you should be doing is avoiding the dentist completely. It is very important to maximize your care by continuing all routine visits such as bi-annual cleanings and examinations. This will ensure that firstly, the status quo is maintained and any potential problem is avoided(preventative approach). Second, if a pathology is diagnosed, it can be treated in a timely manner before it progresses and require more aggressive treatment in the future(minimally invasive approach). Finally, in those instances where multiple pathologies need to be treated, seeing the whole picture will allow you and your dentist to devise an appropriate treatment plan with beneficial sequences(comprehensive approach).
Remember that just as in life in general, ignoring potential and/or existing problems will usually lead to bigger ones.

Tooth Whitening

2009-08-06T06:35:00.000-07:00

Many people are not pleased with the appearance of their own teeth and one of the easiest methods of improving this appearance is by tooth whitening.
Enamel, the first layer of tooth surface, is actually semi-translucent, or clear. The layer underneath the enamel, known as dentin, is typically yellow, but may be gray, brown or black. This hue is what is seen penetrating through the enamel. In order to whiten the dentin, a peroxide solution is placed on the enamel. This process opens the pores of the enamel, allowing the solution to reach the layer of dentin. The solution will then begin to lighten the dentin, resulting in the appearance of whiter teeth.
As far as specific techniques and systems go, there are three basic categories. The first and least effective are over-the-counter products such as whitening strips. The second used to be the only professional option and consists of trays that are made by dentists and worn at home by the patient. The newest and most effective are chairside methods in which the entire procedure is preformed in the office over the course of approximately two hours. In this system a special light is used in conjunction with the whitening agent in multiple applications.
The good news for the patient is that many options are available nowadays and many are proven safe and effective.

A question of priority

2009-07-22T09:18:00.000-07:00

In my 18 years of private practice as a family practitioner and Prosthodontist, I've heard all kinds of excuses for avoiding and/or delaying dental treatment. Regardless of what the excuse is, I think in most cases it is simply a question of priority. Most people can understand, on an intellectual level, that an existing pathology needs to be removed and corrected. However unless the person is in pain or discomfort, they may feel that the recommended treatment can wait or in some extreme cases totally avoided. Of course the problem with this line of thinking is that clinical pathologies never go away and as a matter of fact usually lead to irreversible damage which will require even more treatment down the line. I have seen patients regret not following through with recommended treatment too many times and those who remain consistently healthy are the ones that do not procrastinate!

A comprehensive approach

2009-06-30T12:33:00.000-07:00

The oral cavity or mouth consists of many parts and can roughly be categorized into hard tissues(teeth and bone) and soft tissues(gums, cheeks, palate, etc.). Optimal function and appearance requires that all the parts are healthy. So when it comes to treating the mouth, it is absolutely imperative to apply a comprehensive approach. I've come across many situations in my career where certain aspects of a condition were ignored during previous treatment and as a result the outcome is poor or failing.
Recently, I did an examination on a patient who just had some restorative work and needed a second opinion because he was not pleased with the results. I found that the patient had moderate to severe bone loss(Periodontitis) and had to tell the patient that all the recent work should be removed in order to treat the supporting bone and gums. Needless to say Mr. X was not happy. The moral of this story is to make sure that a thorough evaluation(clinical and radiographic) is performed before a treatment plan is derived and carried out. As we all know, its always better to do it right the first time!

Onlay

2009-06-15T07:24:00.000-07:00

As I have mentioned previously, existing restorations in our teeth do not last forever. Due to a constant wear and tear, older fillings tend to break down over the years. It can be somewhat confusing to the average person as to what is an appropriate replacement for an old and defective filling. There are many choices but as a general rule the proper choice for a replacement is directly proportional to how much tooth structure is remaining after the excavation. So the size of the original restoration is definitely a factor. Another factor is the nature and severity of the defect, meaning how much recurrent decay is present at the time of diagnosis. It is also very important to be conservative and not remove any more healthy tooth structure than is necessary.
In my experience most existing defective fillings are best restored with an Onlay. An Onlay is a type of dental restoration that is the best of both worlds not only in the sense that it provides proper coverage but also it is not overkill in preparation. What happens in most situations is that after a defective filling is cleaned out, the walls that contained the old filling will be too thinned out to support another direct filling especially at the very top of the tooth. Those thin walls are then reduced by a couple of millimeters and the Onlay is fabricated in the Laboratory from an impression of the teeth. The analogy that I like to use is a mushroon shape in cross section where the "cap" covers most of the biting surface and the "stalk" sits in the tooth where the filling was. This design is ideal because we are essentially only removing what is defective. It is also relatively more conservative in preparation than some other choices such as a crown for example. The idea is that the more of your own tooth we can hold on to now, the better off you are in the long run and more options are available in the future.
Onlays are made of a type of porcelain and are bonded in with a resin cement. This is a very strong combination and teeth that are restored in this way will typically not require further treatment for many years.

Interesting facts

2009-06-03T10:53:00.000-07:00

In this post, I've decided to keep it light and just list some interesting facts that are dentally related;
The average woman smiles about 62 times a day! A man? Only 8!
Kids laugh around 400 times a day. Grown-ups just 15.
Smilers in school yearbooks are more likely to have successful careers and marriages than poker faced peers.
More people use blue toothbrushes than red ones.
The average toothbrush contains about 2,5000 bristles grouped into about 40 tufts per toothbrush. The tufts are folded over a metal staple and forced onto pre-cored holes in the head and fused into the head with heat. The handle is made of at least two materials, usually plastic and rubber.
Top of the American teeth stakes in the poll for greatest looking teeth were Hollywood actors Brad Pitt and Julia Roberts.
50 % of the general population consider the smile the first facial feature they notice and 80% are not happy with their smile.
38.5 = the total days an average American spends brushing teeth over a lifetime.
Americans spent nearly $2.025 billion on Halloween candy this year. That would fund the National Institute of Dental and Craniofacial Research for almost six years.
33% of Americans have untreated tooth decay.
90% of systemic disease have oral manifestations.
83% of people believe their teeth are more important to their appearance than hair and eyes.
How people take care of their mouths is often a reflection of how they feel about themselves. At birth the only fully developed organ is the tongue which is needed for sucking. For the first two months of life our mouth is our primary organ. We use it for survival, expressing ourselves and to explore our new world. consequently it is very significant in our unconscious. Because of this it can be assumed that how we take care of our mouths is a reflection of how we feel about ourselves. People who feel good about themselves take good care of their mouth and people who have a poor self image generally do not take good care of their mouth.

Discomfort

2009-05-27T07:51:00.000-07:00

In deciding the topic of my next entry, I always try to put myself in the patients' shoes and think from a patient's perspective. What came to mind recently is the discomfort that most people automatically associate with dental treatment. In my mind the vast majority of the "usual" discomforts of dental treatment can be avoided. In other words an assumption that dental treatment is inherently uncomfortable is false. My staff and I always try to pay attention to the smallest detail in dealing with patients and our priority is to keep our patients mentally and physically comfortable at all times. This attention to detail goes a very long way and the positive reaction of our patients even surprises me at times. Not a day goes by where I don't get a "Wow, that wasn't bad at all" and I take pride in the fact that I am exceeding my patients' expectations on every level. So the next time you find yourself apprehensive at the thought of dentistry, just remember it doesn't have to be that way!

Benign neglect

2009-05-20T09:07:00.000-07:00

Benign neglect is a policy or attitude of ignoring a situation instead of assuming responsibility for managing or improving it. I take this topic very seriously as I've had some experience with it and it's consequences. Years ago when I took over an existing practice, I came to realize that some of the patients did not want any treatment unless they were in pain or half of their tooth fell out! I found myself explaining and educating my patients as to the importance of early diagnosis and treatment of conditions that they were not aware of. Later after some investigating I realized that the previous dentist rarely did a thorough examination and basically if the patients did not have a complaint they were given a clean bill of health and sent on their way. This practice may seem like a conservative approach on the surface but of course it is not only detrimental to the health of patients, but also unethical. It is a proven fact that by the time a patient experiences some symptoms, some irreversible damage has already occurred. For example some recurrent decay under an existing restoration is usually diagnosed at a periodic exam and subsequently the filling and decay are excavated and a new restoration placed. Now, if the same tooth is neglected, the nerve could easily become invaded by the advancing decay and become infected, thus requiring more invasive treatment such as root canal therapy. I feel that it is my professional and ethical duty to use all technological advances at my disposal to make thorough diagnosis on a regular basis and protect the health of my patients in the long run.

Sticking with your treatment

2009-05-14T06:56:00.000-07:00

Some of us are lucky and have very few dental issues in the way of gum disease or recurrent decay.
On the other hand the majority of the population, at one point or another, will develop more than one form of pathology at the same time. In these situations it is imperative to have a comprehensive approach in treatment. Now it's human nature to deal with your problems one at a time and it is totally understandable that to many people problems in multiple areas of their mouth seem overwhelming. I have been told by some of my patients, "why don't we deal with this first and then we'll see....." and over and over again the result is a vicious cycle that never ends! One needs to always keep the big picture in mind. The pathologies that are put on the back burner not only don't go away, but by the next check-up are worse and would require even more invasive treatment. The much wiser approach is to hunker down and try to eliminate all problems as soon as possible. There is always a light at the end of the tunnel and by addressing all issues, one can quickly get back on track.

Dental Implants

2009-05-13T11:04:00.000-07:00

Although you have a number of restorative options for the treatment of missing teeth, none have proven to be as functionally effective and durable as implants. In many cases, dental implants may be the only logical choice for the restoration of all necessary functionality of the teeth and supporting structures. An important advantage of dental implants over more traditional forms of treatment such as a fixed bridge, is that your other teeth are not prepared to hold the prosthesis. Thus they are much more conservative in terms of your own teeth.
Today's dental implants are virtually indistinguishable from other teeth. This appearance is aided in part by the structural and functional connection between the dental implant and the living bone. Implants are typically placed in a single sitting but require a period of osseointegration. Osseointegration is the process by which direct fusion of a dental implant root and the bone of the jaw occurs. An osseointegrated implant takes anywhere from three to six months to anchor and heal, at which point we would complete the procedure with the placement of a crown. Dental implants can also be utilized to replace multiple teeth.

Flossing & Overall Health

2009-05-13T10:38:00.000-07:00

By the time we reach adulthood, most of us know that the consequences of not flossing are pretty tough on our teeth. Daily flossing is a vital part of dental care and promotes healthy teeth and gums. Sounds easy enough. But what if you knew that this simple daily ritual not only protects your mouth, but also may protect your heart and arteries? Suddenly, that little white string becomes more like a lifeline.
True, lack of flossing can lead to gingivitis and periodontal diseases, but the consequences of poor dental health may reach beyond your mouth and to your heart. Research has shown a distinct connection between periodontitis and cardiovascular disease. Researchers speculate that bacteria from the mouth may enter the bloodstream and contribute to inflammation and artery clogging. In one emergency room study, patients who came to the ER with chest pain were found to have a higher rate of recurring gum infections. Researchers are not sure what is behind the connection, but the worrisome data makes the simple task of flossing a no-brainer for optimal health.

"The check-up"

2009-05-12T11:15:00.000-07:00

check-up, recall, re-care, cleaning, prophy, .......it really doesn't matter what you call it but what does matter is that you have at least two a year. I have been a clinician for 17 years and if there is one piece of advise that I could give, it is to never miss your bi-annual dental exam & cleaning.
This may seem very obvious to some but too many times I have seen patients stay away for too long and get into trouble because of it. Regardless of how much or how little treatment you are having, those periodic "check ups" should not be missed. Also one needs to realize that there is no substitute for these visits meaning that just because you have had some other treatment at the dental office doesn't mean you can miss your 6 month cleaning/exam. It is ONLY at these visits that your dental professionals can preform a comprehensive and thorough evaluation of ALL your teeth and recommend an appropriate course of action or alter an existing plan.

LUMINEERS

2009-05-11T05:38:00.000-07:00

Statistics show that many people tend to be dissatisfied with the appearance of their teeth. This is usually due to discoloration, spaces or uneven positioning of teeth. I would like to discuss a possible solution to many of these common issues called Lumineers. Lumineer porcelain veneers are custom designed to give you the beautiful smile you desire and much easier to place than you may have thought. It used to be that when we did a traditional porcelain veneer case, some of the enamel had to be removed from the teeth being treated. This was to make room so the veneers would fit properly and usually required anesthesia and some form of temporization in between visits. However unlike traditional veneers, there are no shots and no drilling of sensitive tooth structures with the Lumineer system. Due to advances in technology, Lumineers are fabricated to be as thin as a contact lens and for this reason there's no reason to make room by removing your own tooth structure. Also, this process actually increases the bond strength between the veneers and the teeth because enamel is the best material to bond to and much less of it is removed with this system. Lumineers have been proven to last over 20 years which is significantly longer than traditional veneers. They’re even reversible. So to summarize one can have a safe and permanent new smile in two easy and comfortable visists that consist of impressions and delivery.

Delaying Treatment

2009-05-07T07:33:00.000-07:00

Putting off recommended treatment is never a good idea, but particularly in dentistry it is guaranteed to aggravate the condition and require even more work down the line. Weather we are talking about some recurrent decay under an old restoration or gum disease, procrastination will ensure more involved treatment and irreversible damage in the future. An old silver filling that is defective can usually be excavated and restored with an onlay, but the same tooth ~6months to a year later may require root canal therapy, post and crown. A relatively mild case of gingivitis, if untreated can escalate into periodontitis and permanent bone loss. So always remember that just like life in general, if problems are ignored they will come back to haunt you!

when to brush and floss

2009-05-06T07:41:00.000-07:00

Everyone knows that we should brush and floss our teeth daily. What's not that clear to some is when is the most important time of day to do it. The answer is before bedtime because teeth and gums are most vulnerable to decay and disease during the night while we sleep. The reason is that when we are sleeping our salivary flow decreases significantly and saliva happens to be a natural defense against cavities and gum disease. Saliva neutralizes the acids that are produced by the bacteria in dental plaque, which would lead to cavities or decay. Any plaque that stays on various surfaces of your teeth overnight can do damage. So all teeth surfaces should ideally be brushed and flossed before bed.

Invisalign

2009-05-06T06:59:00.000-07:00

If you ever wanted to straighten your teeth or improve your bite, but conventional metal braces were out of the question, then Invisalign maybe the answer for you. Utilizing the Ivisalign system we can move teeth into a more desirable position by having patients wear a series of transparant aligners or trays. This technology eliminates the need for conventional metal brackets and wires and is practically unnoticeable. The Invisalign system is a proven method which is also utilized by many Orthodontist and quite simple to employ. My staff and I are trained and certified to provide this service to our patients.

existing restorations

2009-05-05T12:19:00.000-07:00

Contrary to popular belief and regardless of type of restoration( filling, bonding, inlay, onlay, crown, etc.), nothing is truly permanent. The oral cavity is subject to lots of wear and tear and in my experience no matter how well a restoration is placed, eventually it will fail. Now as depressing as this may sound, there is some good news! We can all minimize the risk of dental defects by following certain guidelines such as having good hygiene habits( proper brushing and flossing) and regular check-ups to remove plaque and calculus and to diagnose problems as soon as possible.

Conservative & timely treatment

2009-05-05T07:24:00.000-07:00

One of the most important keys to better dental health are regular check-ups. The American Dental Association(ADA) recommends a minimum of two cleanings and exams a year. Our philosophy is to always do the most conservative treatment as soon as possible when faced with a defect or pathology. By having an examination every six months, we are able to catch and treat most conditions in a timely manner.

The importance of teeth

2009-05-05T06:17:00.000-07:00

It's never too late to improve your dental care. As adults we only have one set of teeth and they are so important in so many ways. Not only are our teeth essential for health reasons but they are also a huge part of our personal and professional appearance, influence and self confidence!