Projecting a healthy, radiant smile can help boost self-confidence and lead to increased comfort and success in both personal and career-oriented situations. Yet, many people are unhappy with their less-than-pearly whites, causing them to avoid social interaction and even lose out on opportunities because they are too self-conscious.

Your dissatisfaction with the appearance of your teeth may also be causing you to stifle one of nature's most endearing and intrinsic impulses, simply smiling!

For example, do you:

• Avoid posing for pictures that require a smile?
• Cover your mouth when speaking or laughing in public?
• Avoid dating because you feel unattractive?
• Feel that people think less of you because your smile is flawed?
• Think your smile makes you look older than you are?

If you've answered yes to any of these questions, you are certainly not alone. A poll conducted by the American Academy of Cosmetic Dentistry found that, while a whopping 99.7% of respondents said they considered a good smile to be a highly important social asset, only 50% of those same respondents indicated that they were satisfied with their own smile. In addition, the Academy reported that people between the ages of 31 and 50 are most unhappy with their smile, are most concerned with making a good first impression through a strong smile, and most frequently seek out information on cosmetic dentistry.

The good news is that advances in cosmetic enhancement and restorative dentistry, including treatments like teeth whitening and the application of porcelain veneers to correct tooth crowding, make it possible for anyone to enhance or improve their smile and boost their self-image. And a complete “Smile Makeover” has been shown to positively impact the perception that others have with respect to attractiveness, popularity, and even wealth — all based on the quality of a person's smile.

Our office can work with you to determine just what it will take to improve your smile and self confidence from as little as a minor enhancement to a complete smile makeover — anything that would best match your idea of the perfect smile. To get started, give us a call.

To read about others who have regained their confidence after brightening and whitening their smiles through cosmetic dentistry, read the Dear Doctor magazine article “The Impact of a Smile Makeover.”

When it comes to cosmetic dentistry, we have numerous techniques that we can use to produce a dazzling smile while restoring or helping you maintain optimal oral health. From tooth whitening and gum contouring to bonding and veneers, see how much you really know about cosmetic dentistry by playing our matching game.

1. Whitening
2. Bonding
3. Enamel shaping
4. Orthodontics
5. Veneers
6. Crowns and bridgework
7. Implants
8. Gum contouring

1. ______ is a minor surgical procedure in which we alter the position of the gum tissue and sometimes even the underlying bone.
2. ______ is a treatment option that is not permanent and may require several applications to achieve the desired color results.
3. ______ is a restorative technique that involves applying an a tooth colored filling material (composite resin) to a tooth that is color-matched and shaped to restore a decayed or damaged tooth.
4. ______ is a treatment option for restoring heavily damaged teeth or replacing missing teeth.
5. ______ is a procedure in which small amounts of enamel, a tooth's outer layer, is removed to reshape it to improve the look of a tooth.
6. ______ is a minor cosmetic procedure in which we apply a peroxide-based material to bleach out minor stains and discoloration from teeth.
7. ______ is a procedure in which we permanently replace a missing tooth by attaching a crown (artificial tooth) to a titanium post that has been surgically placed within the jaw.
8. ______ is a treatment option in which teeth are aligned into a proper position giving a more attractive appearance. It is often used in conjunction with other cosmetic procedures.
9. ______ is a cosmetic technique where we place a custom-designed, thin shell of tooth-colored material (usually porcelain) to the front surface of a tooth.
10. ______ is the most common technique for repairing chipped, broken or decayed teeth. It may also be used to alter the shape of a small or irregular tooth.

Answers: 1) H. 2) A. 3) B. 4) F. 5) C. 6) A. 7) G. 8) D. 9) E. 10) B

To learn more about cosmetic and restorative dentistry, continue reading the Dear Doctor magazine article “Beautiful Smiles by Design.” Or you can contact us today to schedule an appointment to discuss your specific questions.

Our office can design a customized smile for you. We will want to know what you really want changed and we will listen to your ideas, look at pictures of the kind of smile you had when you were younger, and even create computerized pictures of what you think you'd like to look like. And then, with all the modern techniques at our disposal, we'll put together a blueprint, a plan to give you the smile you want.

We will start with a smile analysis to determine your facial balance, which indicates how all of the elements of your smile currently relate to each other. These elements include much more than just the teeth, such as the shape of your face, skin color, eye color, lip form, and smile dimensions to name a few.

A detailed periodontal evaluation, which includes bone and gum tissues — the supporting structures of the teeth — will determine whether the foundations of your teeth and bite are healthy. Similar to the way you would ensure that the foundation of a house is intact before you renovate, we will make sure that your periodontal tissues are healthy and sound before we begin a smile makeover.

Modern restorative dental techniques include teeth whitening, enamel reshaping, gum contouring, porcelain veneers and crowns, or a combination of several of these procedures. In some cases, orthodontic treatment (braces) or clear aligners may be necessary to ensure that the teeth are in the best position for both the aesthetics and function of your new smile.

We will inform you of all the possible paths that can lead to the final desired outcome, and will discuss all the benefits, alternatives, and risks together with the time it will take and the finances involved. Bottom line — we'll find a way to get you what you want and need, a new smile, with improved function as well as appearance. We'll also provide instruction on all that you need to know and do to keep your new smile healthy and to maintain your investment for years into the future.

So, if you have been unhappy with your smile and would like to revamp it, call our office to learn about how a smile redesign could help boost your self-image. To find out more about the details involved in a smile makeover and to view some before and after photos, read the Dear Doctor magazine article “Beautiful Smiles By Design.”

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!

The eruption of your child's first permanent teeth is a milestone in his or her development. As parents, you want to help your child preserve and protect their new permanent teeth so that they can last a lifetime. Dental sealants are one easy, simple, and inexpensive way to protect them from decay.

How do cavities develop?

The back teeth (premolars and molars) are formed with deep grooves on their biting surfaces that we call “pits and fissures.” These crevices are too deep for toothbrush bristles to reach. Bacteria can therefore grow and thrive inside them. The acid produced by these bacteria begins to dissolve the tooth enamel, starting the decay process.

Are new teeth more vulnerable?

Yes, the enamel surface of newly erupted teeth is more permeable and less resistant to tooth decay. As the enamel matures, it becomes more resistant.

How can you prevent decay in these new teeth?

Good oral hygiene habits, nutrition (including low sugar consumption), together with fluoride, sealants, and regular dental visits strengthen the teeth and can dramatically reduce tooth decay.

How does fluoride protect these teeth?

Fluoride makes the enamel surface harder and more impermeable and, therefore, less susceptible to acid attack and decay. Fluoride adds some protection to the deep pits and fissures of the teeth but they are still at high risk because of their shape and they often need further protection.

What are sealants and how do they work?

Sealants are protective coatings placed in the tiny pits and fissures to seal them from the bacteria and acids that promote decay. They actually “seal” the pits and fissures to prevent decay and can be used in the treatment of very early decay by arresting it. Greater use of sealants could reduce the need for subsequent treatment and prolong the time until treatment may become necessary.

Contact us today to schedule an appointment or to discuss your questions about dental sealants for your children. You can learn more about them by reading the Dear Doctor magazine article “Sealants for Children.”

For many brides and grooms, planning for their wedding is something they start weeks, months or even years in advance. Obviously for most couples, these plans include finding the perfect location, dress, reception area, florist and caterer. However, a growing number of couples (and parents of the bride and groom) are also looking to cosmetic dentistry prior to the wedding. A smile makeover to correct an issue and boost self-confidence makes sure that your wedding pictures are truly memorable.

If this sounds like you, take the first step towards the smile you have always wanted. To create your ideal smile, we will first meet with you to hear your concerns, goals, expectations and wedding day timeline. Feel free to bring in photos or magazine images of smiles that illustrate exactly what you want, do not want, as well as images of smiles that you consider beautiful. We will give you a thorough examination, review photos you bring with you and ensure that everyone understands and agrees with your smile makeover treatment decisions. You will also be informed about what you should expect immediately prior, during, and following your treatment.

We pride ourselves on using the latest technologies and techniques to restore natural-looking smiles. Our smile makeovers have a two-fold design plan in that we artistically create the cosmetic look you want while ensuring you obtain optimal functionality and oral health. After all, we all on the same team for helping you achieve the look you want for your wedding and maintaining your smile for years to come.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more when you continue reading the Dear Doctor article, “Wedding Day Smiles.”

If you've lost one or more of your teeth due to tooth decay, trauma, gum disease or a failed root canal, there are a variety of ways that our office can help you to restore your smile and increase your confidence. Crowns, conventional bridges and dentures aren't your only options for replacing missing teeth. Dental implants, surgically placed below the gums, are another alternative for replacing missing teeth.

Getting Started: If you would like to explore the option of having dental implants to replace one or more teeth, you will first need a comprehensive exam. The ideal candidate for implants is in good general and oral health. Adequate bone in your jaw is needed to support an implant. Smokers and those with uncontrolled chronic diseases like diabetes may not be good candidates for dental implants because healing may be impaired or slow. In addition, dental implants aren't appropriate for children or teens until their jaw growth is complete.

The Process: Dental implant surgery can be performed in our office using either a local or general anesthetic. The implants actually replace tooth roots; they are placed into the bone surgically. Generally made of commercially pure titanium, this metal has the remarkable ability to fuse with the bone as it heals forming a union known as osseointegration (“osseo” – bone; “integration” – to fuse with). This process takes two to six months depending upon many factors of which bone quality is the most important.

The next step is to place an abutment (a small connector) which attaches the implant to the crown. The crown is the part of the tooth that is normally seen in the mouth above the gums.

Assessment of your individual situation and deciding if dental implants are right for you takes knowledge and experience. Contact us today to schedule an appointment to discuss any questions you may have regarding dental implants. Read more about this topic in the Dear Doctor magazine article “Dental Implants: Options for Replacing Missing Teeth.”

Test yourself on your knowledge of this dental procedure.

1. A root canal is
1. A canal shaped structure in the root of your tooth
2. A blood vessel carrying blood from your gum to your tooth
3. An instrument used by your dentist in performing dental surgery
2. Which of these are symptoms of root canal infection?
1. Sharp, acute and intense pain, which is difficult to pinpoint
2. Sharp pain when biting down on your tooth or on food
3. Lingering pain after eating hot or cold foods
4. Dull ache and pressure
5. Tenderness (accompanied by swelling) in the nearby gums
6. All the above
3. If you don't feel any pain you do not have a root canal infection.
1. True
2. False
4. Root canal treatment is a very painful experience.
1. True
2. False
5. Root canal treatment is called endodontic therapy. What does this word mean?
1. Bringing the end of your problems
2. Inside your tooth
3. Fighting gum disease
6. You need root canal treatment if
1. The inside or pulp of your tooth becomes inflamed or infected
2. Your tooth needs to be gently moved in order to correct your bite
3. Acid erosion is damaging your tooth
7. During root canal treatment the canals in your teeth are cleaned out and sealed off.
1. True
2. False
8. Who is qualified to perform root canal treatment?
1. General dentists
2. Endodontists
3. Both of the above

1. a. A root canal is a canal shaped space within the root of a tooth that holds the tooth's pulp — which contains the tooth's nerves and blood vessels.
2. f. — all of the above
3. False. It is possible to have an infection that has stopped hurting but is still present and causing damage.
4. False. Root canal treatment doesn't cause pain, it relieves it.
5. b. The word comes from roots meaning “inside” and “tooth.”
6. a.
7. True. A small opening is made in the chewing surface of your tooth to gain access to the pulp. Dead and dying tissue is removed and the pulp is cleaned and disinfected. The canals are shaped and then sealed with filling materials to prevent future infection.
8. c. All general dentists have received training in endodontic treatment and can perform most endodontic procedures. They often refer people needing complicated root canal treatment to endodontists, who have had specialized training in endodontic diagnosis and treatment.

Your car comes with a maintenance manual that tells you when to get an oil change, rotate the tires, and perform other necessary tasks. By following the manual's directions you can keep your car running in good condition for many years. Too bad a manual doesn't come with your teeth and gums!

Such a manual would concentrate on a few basic tasks we call oral hygiene and teeth cleanings. Both tasks are mainly dedicated to removing dental plaque or biofilm from the surfaces of your teeth and the surrounding gums. Plaque is now referred to as a biofilm, a film composed of bacteria, that naturally forms in your mouth. Studies have shown that dental plaque causes periodontal disease (gum disease) and dental caries (tooth decay).

Tips for Daily Removal of Dental Plaque
The way you hold your toothbrush is crucial to your ability to remove plaque effectively. We recommend that you hold it in your fingertips as you would a pen or pencil. Use small motions and pressure. Brushing too hard can damage gum tissues. Use a soft bristled brush, hold it at about a 45 degree angle to the gum line and then use a gentle scrubbing motion. Studies have shown some electric toothbrushes to be more efficient at plaque removal than hand-held brushes; but in general how you use the brush is more important than what kind of brush it is.

To remove plaque deposits from the hard-to-reach areas between your teeth, floss at least once a day. Wrap the floss around each tooth surface and gently move it up and down for a few strokes, cleaning the sides of your teeth where they face each other.

You can use an antibacterial mouthrinse to get help reduce the bacterial plaque or biofilm that you missed in brushing and flossing.

The best way to make sure you are brushing correctly is to have a dental professional demonstrate for you. We would be happy to demonstrate the correct techniques in your own mouth so that you can see how it feels, and you can copy the methods we use.

Professional Maintenance Schedule
Your car needs to go into the shop from time to time for professional maintenance. Your teeth also need a regular schedule of maintenance from a professional dentist or hygienist. Over time, plaque that you do not manage to clean off your teeth accumulates and forms hard deposits called calculus or tartar. If left on your teeth these deposits cause inflammation of your gum tissues and can lead to infection, abscesses, and even tooth loss. During a professional cleaning a technique called scaling removes these substances. For more advanced forms of gum disease, root planing is used to remove deposits of calculus below the gum line.

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.”

Cavities used to be nothing to smile about, but thanks to advances in technology, tooth-colored fillings have made repair of decayed teeth so natural, they're invisible. Now you no longer need to feel self-conscious about that unsightly flash of silver when you talk or laugh. While silver amalgam fillings were once the preferred option for tooth restoration filling materials, tooth-colored “composite resins” have gained popularity as a safe and effective alternative to treat new cavities or to replace old silver fillings.

A Better Alternative: Consumer demand for tooth-colored (metal free) restorations as well as the dental profession's desire to preserve as much natural tooth structure as possible has led to the development of special “adhesive” tooth-colored materials. Besides the aesthetic advantages over amalgam fillings, tooth-colored fillings require the removal of less tooth structure. While traditional silver fillings often crack or leak over time, composite resin fillings bond directly to tooth structure and actually reinforce and strengthen it while creating a natural looking smile.

The Choice is Yours: You can choose to replace unsightly silver fillings with tooth-colored ones to enhance their cosmetic appearance. Although concern has been expressed over the mercury content in older silver fillings, years of research cited by the American Dental Association has found that traditional amalgam fillings are safe. Unless you have cracks or damage to your current amalgam fillings or have other concerns regarding your dental health, replacing silver fillings is a matter of personal preference.

Cost: Although composite resin fillings may cost slightly more than silver fillings, they are very durable and may be more cost-effective in the long run.

Contact us today to schedule an appointment to discuss any questions you may have regarding tooth colored fillings. Read more about this topic in the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”

When it comes to replacing missing teeth, we have numerous options. However, two of the most common treatment options include bridgework and dental implants. See how much you really know about dental implants and bridgework by taking our quick and easy true/false self test.

1. When it comes to costs, dental implants may initially cost more than bridgework but are less expensive than bridgework over a lifetime.
   True or False
2. Both bridgework and dental implants can last a lifetime when properly maintained.
   True or False
3. Prior to placing a three-unit fixed bridge, if the surrounding teeth have crowns, they must be redone so that the bridge fits and wears properly.
   True or False
4. Replacing a single tooth with a three-unit bridge, requires removing the enamel on the adjacent teeth even if these teeth are disease-free.
   True or False
5. In addition to being permanent tooth replacements, another advantage of dental implants is that they don't decay like teeth supporting bridgework.
   True or False
6. It is not uncommon for root canal treatment to be required to save teeth that support bridgework if they have been subjected to severe decay and their nerves become infected.
   True or False
7. Placing a dental implant requires more time when compared to placing a three-unit bridge.
   True or False
8. Both bridgework and dental implants require minor surgery to replace a missing tooth.
   True or False
9. Dental implants are more desirable than bridgework because placing them does not affect the adjacent teeth.
   True or False
10. Studies indicate that bridges are only 67% successful at 15 years whereas dental implants have success rates into the 90s.
    True or False

Answers: 1) True. This fact shocks many people. 2) False. This is more commonly true for dental implants. 3) True. 4) True. This is one of the disadvantages of bridgework. 5) True. This is just one of the advantages of a dental implant. 6) True. 7) True. 8) False. Dental implants require surgery to be placed. 9) True. This fact is a significant advantage for dental implants. 10) True. Your results may vary; however, this statistic represents what you might expect.

To learn more, continue reading the Dear Doctor magazine article “Implants vs. Bridgework.” Or, you can contact us today to schedule an appointment or to discuss your questions.

Nearly everyone has snored at some point in life. However, if your sleeping partner routinely tells you that you suffer from this problem, you really should take action to confirm or deny your suspicions. You may be like one of the 50 to 70 million people in the US alone that suffer from Obstructive Sleep Apnea (OSA), a medical condition in which the upper airway (the back of your throat) collapses during sleep thus limiting your intake of oxygen. And this condition is serious. If left untreated, OSA can lead to a stroke, impotence, an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease.

The first and most important step you should take if you snore is to obtain a thorough examination by both your primary-care physician and our office. We have completed specialized training in sleep medicine so that we can not only diagnose but also thoroughly treat your sleep disorders.

If you are diagnosed with this problem, relax. We have many ways we can treat your condition. One of the most common methods is to provide you with oral appliance therapy. This first line of treatment involves our making a customized oral appliance (mouthpiece) that will hold your lower jaw forward. By doing this, we can move your tongue away from the back of your throat so that your airway is less likely to get blocked while you sleep. (It is this blockage that causes the infamous snoring sound.)

Another option we may consider using to treat your sleep apnea if it is moderate to advanced is a Continuous Positive Airway Pressure (CPAP) machine. These machines require you to sleep with a mask over your nose and/or mouth and produce continuous pressure in your windpipe so that your tongue is forced forward away from your airway. Not only can these machines potentially eliminate your snoring, but they can also give you the restful night's sleep that you have been missing.

The last and most permanent solution for treating certain non-responsive cases of sleep apnea is surgery. This option is typically reserved for the most advanced cases to eliminate or reduce an obstruction to the airway.

Contact us today to discuss your questions about sleep apnea or to schedule an appointment. You can also learn more about sleep apnea when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

1. Xylitol is a kind of sugar.
   True or False
2. Xylitol is made from
   1. Bark of birch trees
   2. Coconut shells
   3. Cottonseed hulls
   4. All of the above
3. Xylitol is a natural “sugar alcohol” similar to other so-called sugar alcohols such as mannitol and sorbitol.
   True or False
4. Xylitol is broken down by decay-causing bacteria to produce acid.
   True or False
5. Decay-causing bacteria are transmitted from a parent to a child through oral contact such as a simple lip-to-lip goodnight kiss.
   True or False
6. Researchers have found no difference in prevention of tooth decay in gum made from xylitol compared to gums containing sorbitol/xylitol and sucrose.
   True or False
7. Other xylitol products such as mints, candy and cookies also seem to decrease the incidence of tooth decay.
   True or False
8. Xylitol products increase salivary flow and allow saliva to neutralize acids in your mouth.
   True or False
9. The only side effect of too much xylitol ingestion is a possible mild laxative effect.
   True or False
10. The target dose of xylitol is one to two teaspoons spread throughout the day.
    True or False

1. True. Xylitol is a kind of sugar that does not contribute to tooth decay.
2. All of the above. It is also found naturally in some fruits and vegetables.
3. True. The others, mannitol and sorbitol, are used as sugarless sweeteners.
4. False. Unlike sucrose (table sugar), xylitol is NOT broken down by bacteria to produce acid. Xylitol also stops saliva from becoming acidic so your mouth becomes an unfriendly environment to acid-producing bacteria.
5. True. However, xylitol inhibits growth and attachment of the bacteria to your teeth, so it also inhibits transmission to your children.
6. False. Systematic use of xylitol chewing gum significantly reduces the relative risk of caries (tooth decay) when compared to chewing gums containing sorbitol/xylitol and sucrose. Xylitol gum also appears to halt the development of tiny cavities when compared to other types of chewing gum.
7. True. Use of these products seems to stop the progression of active decay.
8. True. Xylitol and your saliva combine to re-mineralize (harden) your teeth after an acid attack.
9. True.
10. True. This means two pieces of xylitol gum or two pieces of xylitol candy or mints should be consumed for five minutes four times a day after eating meals or snacks.

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.”

Let's talk about oral cancer. Yes, it's a scary subject — but the truth is, the more you know about it, the better able you are to protect yourself.

1. Who is more likely to get oral cancer? Because of your genetic disposition — heredity — men are twice as likely to develop oral cancer as women. African-Americans have a higher incidence than Caucasians. The disease is also related to aging, although in recent years many young people have been diagnosed with this disease.
2. Are some habits related to development of oral cancer? Risk factors include use of tobacco in any form, both smoking and chewing, chronic exposure to sun, and consumption of alcohol. Moderate to heavy drinkers have a three to nine times greater risk than non-drinkers. Tobacco smokers are at five to nine times greater risk than non-users, and users of snuff or chewing tobacco are at four times greater risk than non-users.
3. Where do most oral cancers occur? The most common areas are in the mouth itself, the lips, the tongue, and the pharynx (back of the mouth and throat).
4. What are the statistics for survival after treatment for oral cancer? Conquering cancer depends most on early detection. Since most cases of oral cancer are discovered at a late stage, survival is poor, with less than 60% surviving five years after treatment. When oral cancers are detected early, the survival rate is more than 80%.
5. What are some of the symptoms of oral cancer? Most oral cancers are “squamous” (small scale-shaped) cell carcinomas in the lining of the mouth. Signs of these cancers can be seen as white or red patches in the early pre-cancerous stage. These develop into an ulcer that does not heal.
6. When should you seek medical help? If you notice color changes (white or red patches) or sores or ulcers anywhere in your mouth that do not heal within two or three weeks, go to your dentist for a checkup right away. Sometimes the sores resemble cold sores. A definitive diagnosis requires a tissue biopsy, in which a small piece of tissue is removed under anesthesia and taken to a lab for microscopic examination.
7. What about regular routine examinations? An oral cancer examination should be part of your visit to our office. We will inspect your face, neck, lips and mouth for signs of cancer, feel the floor of the mouth and sides of the neck for any lumps, examine your tongue and the back of your throat. The American Cancer Society recommends a cancer related check-up annually for all individuals aged 40 and older and every three years for those between 20 and 29.

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

If you see blood when you brush or floss your teeth, it generally indicates a problem with your oral health. You may think you are brushing too hard, but this is not usually why gums bleed. The usual culprit is dental plaque.

Plaque is the sticky, whitish film of bacteria that forms on your teeth every day. If you brush regularly, you probably remove most of it — but some may remain behind and accumulate where your teeth meet your gums, particularly between your teeth. As the bacteria build up, along with by-products of their metabolism (the chemical reactions that maintain their lives), they cause inflammation, called gingivitis, in the adjacent gums.

Bleeding gums are an early symptom of gingivitis. Continuing contact with plaque at the gum line can cause your gum tissue to separate from nearby teeth, creating pockets in which the inflammation becomes even worse. The process leads to periodontal disease (“peri” – meaning around, “odont” – tooth). The increasing infection can eat away the bone that anchors the teeth, leading to possible tooth loss. Periodontal disease is not an uncommon problem. About 90% of the population has bleeding gums at some time or another, and approximately 10% go on to develop periodontal disease.

When you lose bone around your teeth, the gums separate from the tooth and “pockets” form between your teeth and gums. The inflammation and infection may continue within the pockets even if your gums have stopped bleeding when you brush. That's why it is important to have regular dental exams — to check up on and stop periodontal disease before it has a chance to cause serious damage.

There may also be other reasons for bleeding gums that have to do with your general state of health. Women who have elevated levels of hormones caused by birth control pills or pregnancy may experience an increased response to plaque that makes their gums bleed more easily. Increased bleeding in your gums can also be caused by some diseases or as a side effect of some medications.

The most important way to prevent bleeding gums is to learn proper brushing and flossing techniques so that you effectively remove plaque from your teeth on a daily basis. If you are not sure you are using the right techniques, make an appointment and have us demonstrate at your next dental visit.

With all the best intentions, some plaque may remain. Plaque that is allowed to stay on your teeth hardens into a substance called tartar or calculus. This must be removed periodically with a professional cleaning by me or by our hygienist.

With not too much effort, you can ensure that your teeth are clean and plaque free, and your healthy gums no longer bleed.

Contact us today to schedule an appointment to discuss your questions about bleeding gums. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums.”

One question we are most often asked by parents of athletes or those who participate in physical sports is, “Do mouthguards really work?” And when we respond, “yes,” a common follow-up question is, “Is there any scientific evidence to support this claim?” Based on this scenario, we feel it is important to provide you with some interesting and evidence-based facts on this topic.

The first reported use of mouthguards was in the sport of boxing. And because participants and bystanders in the 1920s quickly witnessed their effectiveness even back then, the trend's popularity grew to the point that boxing became the first professional sport to require them. However, other sports soon started following this lead — especially those high-contact sports. The American Dental Association (ADA) started mandating the use of mouthguards for football in 1962 and the US National Collegiate Athletic Association (NCAA) currently requires mouthguards for football, ice hockey, lacrosse and field hockey. The ADA has since expanded their recommendations to now include 29 different sports and exercise activities. So now that you know more about the professional organizations pushing the use of mouthguards, let's get back to the second question, “What's the evidence?”

There have been numerous studies over the years regarding the properties of mouthguards, and more specifically their shock absorbing capabilities. Other studies have been based upon their protective abilities due to their stiffness, hardness and strength. This research has enabled us to vastly improve upon the effectiveness of mouthguards. For example, years ago latex rubber was a popular material used to create mouthguards. However, today we use products such as ethylene vinyl acetate or polyurethane because they are far superior in durability and flexibility. And impact studies have shown that the chances of fracturing teeth is dramatically reduced when wearing one of these mouthguards...especially when compared to individuals wearing no mouthguard at all. In fact, research has revealed that by not wearing a mouthguard during physical sports or exercise, individuals are 60 times more likely to experience an injury to the mouth and/or teeth.

To learn more about the importance of protective mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards.” Or you can contact us today to schedule an appointment to discuss your questions about mouthguards.

It is always good to be prepared before you have any dental or medical procedure. Make sure that you are informed and know what to expect to make you as comfortable as possible. We recommend that you have a list of questions with you to ask us during your consultation. If we inform you that you need a crown, consider asking any or all of the following questions:

• Am I a good candidate for a crown?
• Can you do a computer-generated mock-up of my new smile with crowns? (This question is only applicable if the crown is for a front or visible tooth.)
• Is there a way that I can “test-drive” my new smile and crown(s) before making them permanent?
• How long will the entire process take from my first appointment through completion?
• What are the risks, benefits and alternatives associated with the type of crown(s) you are recommending?
• Is there any discomfort associated with crown procedures?
• Will I need or receive any type of sedation when you prepare (drill) the tooth or teeth for a crown?
• Is what you are recommending commonly done?
• Can you show me some before and after photos of cases that you have done?
• How much will my crown(s) cost?
• Will my insurance cover all or a portion of the cost?
• How long can I expect my crown(s) to last?
• Will there be any maintenance required with my crown(s)?

To learn more about crowns, read the Dear Doctor article, “Porcelain Crowns & Veneers.” Or you can contact us today to discuss your situation and schedule a consultation.

For generations, root canal treatment has received a bad rap. Thought to cause pain, it is actually just the reverse. The truth is that root canal treatment does not cause pain but actually relieves it. Not only does root canal treatment relieve pain, it literally saves the affected tooth or teeth from further damage and/or loss.

To get started, let's define this procedure. A root canal treatment is a procedure in which the diseased pulpal tissue in the root canals are removed, disinfected, cleaned, and sealed. This is usually necessary following inflammation and infection of the pulp — which is the cause of your pain — as a result of severe decay or in a very heavily filled or damaged tooth.

However, if left untreated, an infected tooth can spread into the bone and even cause an abscess — and that can be more painful and impact your overall general health. The good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, it can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our offices as soon as you feel you have a problem with a tooth.

If you are having pain from a tooth or several teeth, you may need a root canal treatment. Please contact us today to schedule an appointment before it gets worse. To learn more about the signs, symptoms, and treatment for a root canal, read the article “Common Concerns About Root Canal Treatment.”

Hearing the news that you need a root canal often causes anxiety for most people given all the bad press this procedure has received (e.g., “I'd rather have a root canal than...”). However, the truth is that root canal treatment relieves pain; it doesn't cause it. And it is typically highly successful. The real pain occurs for most people when decay is left untreated or the nerve in a tooth under a very large filling becomes infected and dies.

For these reasons, we have put together the following list of questions you should consider asking prior to having a root canal or endodontic (“endo” – inside: “dontic” – tooth) treatment.

• Am I a good candidate for root canal treatment?
• Does it hurt to have a root canal?
• What can I expect if I do not have a root canal treatment?
• Are there any other treatment options for me given my situation? If so, what are they?
• Do you do root canal treatment or should I see a specialist?
• How long will the entire process take from my first appointment until my root canal treatment has healed?
• Will the pain I am in immediately subside after a root canal or will it take some time?
• Will I need or receive any type of sedation while having the treatment?
• Are there any risks associated with root canal treatment? If so, what are they?
• How long can I expect my natural tooth to last after root canal treatment?
• What could happen to cause a root canal to require a second treatment?
• How much will my root canal cost?
• Will my insurance cover all or a portion of the cost?
• Will the tooth be as strong after root canal treatment, or will it need a crown?
• Will there be any special maintenance required on an ongoing basis after I have a root canal?

To learn more about root canals, continue reading the Dear Doctor article, “I'd Rather Have A Root Canal.” Or if you feel you may need a root canal or other dental procedure, contact us today to schedule a consultation.

Considering that over 90 million Americans suffer from chronic bad breath and everyone else has dealt with some form of it at one time or another, we want to address some common causes and cures so you are prepared if it happens to you.

What are the most common causes of bad breath?

Halitosis or bad breath most often occurs when you have poor oral hygiene and/or routinely consume odorous foods and drinks. In fact, 90% percent of mouth odors come from the food you eat or bacteria that’s already there, according to the American Dental Association. Other causes for halitosis include:

• Excessive bacterial growth in the mouth and especially on the tongue
• Known and characteristically odor producing foods and drinks such as onions, garlic, coffee, tobacco and alcohol products
• Diabetes and diseases of the liver and kidneys
• A poorly hydrated body (and mouth) from not drinking enough water everyday

What should I do if I feel (or people tell me) I have chronic bad breath?

Contact us to schedule an appointment for a proper diagnosis and plan of action for returning your mouth to optimal health.

What are some tips I can do to prevent occasional bad breath?

In most cases, bad breath is totally preventable when you follow the tips below:

• Brush your teeth in the morning and at bedtime using a fluoride toothpaste and a proper (and gentle) brushing technique.
• Floss your teeth at least once a day.
• Clean your tongue after brushing your teeth with either a scraping tool you can purchase at a drug or discount store or by gently brushing it with your toothbrush.
• Keep your mouth moist by drinking plenty of water during the day.
• Be prepared by having some mouth cleaning tools (floss, a toothbrush, toothpaste or some sugar free gum) handy to freshen your mouth after consuming bad smelling foods, drinks or using tobacco or alcohol.
• Eat fresh fruits and vegetables to increase saliva production in your mouth and help remove food particles that can lodge between teeth.
• Maintain regular dental check-ups.

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about halitosis by reading the Dear Doctor article, “Bad Breath — More than Just Embarrassing.”

Tongue and other piercings are a current fad or trend, but can often lead to unforeseen problems.

Piercing the tongue and installing a metal ornament called a tongue bolt commonly leads to chipped teeth, sensitivity, and pain. More frequently, it can cause problems with the gums, such as recession, inflammation, infection, bone loss, and even nerve damage.

In one case reported by the American Medical Association, a teenager suffered 20 to 30 daily electrical shocks in many areas of her face after having her tongue pierced and installing a tongue bolt. A neurologist found that the bolt irritated the nerves to her tongue, causing the symptoms. After the bolt was removed, the shocks and symptoms ceased and her tongue healed.

Having the bolts placed may be painful. The tongue is rich in nerves and blood vessels and a lot of bleeding can occur, which can be difficult to stop. Think about how painful it is when you bite your tongue or lip accidentally. And tongue and lip bolts are not generally placed by health professionals or under sterile conditions.

If you are considering getting an oral piercing, make an appointment with us to discuss all the possible ramifications before you make the decision to go ahead. If you already have an oral piercing, be sure to come in for frequent checkups.

Contact us today to schedule an appointment to discuss your questions about oral piercings. You can also learn more by reading the Dear Doctor magazine article on “Body Piercings and Teeth: The dangers of tongue and lip piercing.”

Thanks to technological advances, today there are more than 40 types of traditional or standard implants. A traditional dental implant actually replaces the root of a tooth, upon which a crown is built — the part you see in the mouth. There are 2 others types that are quite similar to standard implants. Mini implants are most like traditional implants except they are smaller in diameter. Micro-mini implants are an even smaller variation with an even narrower, more screw-like appearance. Micro-mini implants are also designed to be used on a temporary basis, thus can easily be removed. Together all of these types of implants provide us with a wide variety of options for permanently replacing missing teeth.

The following list details the types of implant restorations:

• Single tooth replacements: As the name suggests, these implants are used to replace single teeth.
• Multiple tooth replacements: Implants can be used to replace multiple teeth in a variety of ways. This includes acting as bridge supports to permanently replace missing teeth.
• Combinations of fixed and removable bridgework: Dental implants can be used to support permanently fixed in teeth, bridgework or removable bridges or dentures. Their biggest advantage over dentures alone is that they stabilize the dentures and preserve the jawbone to which they attach, thus preventing the jawbone from melting away under the pressure of dentures.
• Over-dentures: These restorations are now considered the new gold standard. In this application two or more standard implants (or multiple mini-implants) are used to attach and stabilize full dentures. Over-dentures are especially useful for tooth replacement in the lower jaw, where denture stability is often problematic.
• Temporary Anchorage Devices (TADS): These special implants are a tool that orthodontists can use to obtain a stable, non-movable anchor for moving teeth more quickly and easily. They are small, easy to place and easy to remove once their job is done.
• Temporary bridgework: In this case, mini-implants are used to support temporary bridgework. They are placed between permanent implants and later removed when the permanent implants have healed and teeth are permanently placed on them. Mini-implants ensure that a person is never without teeth during the process of teeth replacement.

To learn more on this topic, read the Dear Doctor article, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

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.”

Both diabetes and gum (periodontal) disease are chronic inflammatory diseases that have negative consequences for millions of people worldwide. But before we continue, let's define these two diseases:

Periodontal disease is a condition in which biofilms of dental bacterial plaque stick to teeth near the gum lines causing the gum tissues to become inflamed and infected. If not treated properly and in an early stage, it can cause severe damage to the bone that supports the teeth, resulting in tooth loss. It occurs in the absence of good oral hygiene which includes ineffective daily brushing and flossing and neglecting to see your dentist.

Diabetes is a chronic condition in which blood glucose (sugar) levels become excessive. Glucose is the body's main source of sugar for energy. The hormone insulin, among other mechanisms, normally controls glucose. Prolonged elevated blood sugar levels are harmful and ultimately can even be life threatening if left untreated. With type 1 diabetes, insulin injections (shots) are required to maintain the proper blood sugar levels because the body no longer produces its own blood sugar. Type 2 diabetes is generally less severe and can usually be treated with a combination of diet and medication.

And while both of these diseases share the same common enemy, you, there is scientific evidence revealing links between the two. Diabetes increases the risk factor for developing periodontitis, and conversely, periodontal disease makes it more difficult for diabetics to control blood glucose levels.

Want To Learn More?

Learn more about these two diseases and their relationship by reading, “Diabetes & Periodontal Disease.” Or if you have diabetes but haven't had a dental exam and cleaning in a long time, contact us today to schedule a consultation. You can also use this consultation to discuss any questions or concerns you have about your oral health and its relationship to your diabetes.

Invitations, dresses, the cake, the photographer: there's so much to think about when planning your wedding. And remember to plan for one more thing, your smile. Your wedding photographs will record the magic of your wedding day forever, so you'll want your smile to look radiant. Bonus: you'll be providing for a lifetime of good oral health.

Start planning as far ahead as possible. We can help you select from the variety of treatments, therapies and procedures that can enhance your smile on that special day. Together, we'll assess your starting point, decide what needs to be changed, and create a plan of action. Remember that the bigger the changes you want to make, the longer they are likely to take.

Plan the indicated amount of time before your wedding for the following:

• Several months to three years: Orthodontics
  From minor movement using clear aligners to full braces to correct a bad bite, this treatment allows us to accurately and precisely move teeth for better appearance and function. The process can seem like magic.
• Six months to a year: Dental Implants
  Implants are natural looking, functional stand-alone tooth replacement systems. They take planning and time. An implant consists of a root replacement that permanently joins to the bone and to which a crown is attached.
• Two to four visits: Periodontal Plastic Surgery
  Consult with us to find out your needs. Today, surgical techniques can alter your gum tissues and their relationship to the teeth, improving the appearance of your smile.
• Multiple visits over one to four months: Crowns and Bridges
  A crown or “cap” is generally required when a tooth has been ravaged by decay or trauma. A crown can also be used to improve tooth color and shape. Missing teeth can be replaced by bridges, which span the space created by a missing tooth. Bridges do require crowns on the adjacent teeth to which the bridge is attached.
• At least three months: Veneers
  Porcelain veneers are bonded directly to the enamel to change the shape and color of darkened or unsightly teeth. Usually, a small amount of enamel must be removed to make room for the veneers and for them to work their magic.
• At least two months ahead of your wedding day: Bonding
  You can replace anything from small chips on your front teeth to broken discolored old fillings with the latest tooth-colored bonding composite resin materials. These procedures, generally done in one visit, provide life-like restorations that become part of the teeth and look very natural.
• Allow for one or two office appointments: Whitening
  A professional “in office” tooth bleaching procedure is quicker and more predictable than an “at-home” kit, which may brighten your smile by several shades, but requires months.
• Schedule well ahead of your wedding date: Dental Cleanings
  Remove unwanted stains and freshen your breath, so you look and feel your best on the big day. You may need more than one cleaning, depending on how much stain and tartar there is and how long it has been since your last cleaning.

We can make sure that your wedding day smile makes you look and feel great, not just for those treasured photos, but for years to come. For many of these procedures, results can last a lifetime. Contact us today to schedule an appointment to prepare for your best wedding smile. For more information read the Dear Doctor magazine article “Wedding Day Smiles.”

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.”

When it comes to chronic pain, one of the most common problems you can face is Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ). TMD is a condition that can be tricky to diagnose because it frequently mimics other conditions. This is why many healthcare professionals refer to it as “the great imposter.” However, regardless of what it is called, the pain it causes is real and can become quite severe — especially if left undiagnosed and untreated.

To grasp the condition fully, you must first understand the TMD pain cycle. It can start with any traumatic, psychological, metabolic, or mechanical stimulant that causes spasm in the muscles that move the jaw joints (opening, closing, chewing, and even smiling.) This is because of the constricted blood supply to the muscles resulting in less oxygen along with the accumulation of waste products. This is followed by chemical changes in the muscles and a buildup of lactic acid due to muscle fatigue. Abnormal or involuntary muscle contractions or spasms lead to pain signals to the brain that can stop muscle movement. Depending on the severity, this cycle can repeat itself resulting in acute pain that may be extremely severe at times. The pain may then seem to disappear only to resurface again later. The good news is that our office has highly trained professionals who cannot only diagnose but also treat your TMD.

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

CAMBRA — Caries Management By Risk Assessment

Worried about tooth decay? Dental Decay is one of the most common and infectious diseases known to man, but it is also very preventable. Today, it is even possible to determine your risk for getting tooth decay. There are disease indicators and risk indicators that can be assessed and used to determine your chances of getting tooth decay. And more importantly, they can be used to prevent and reverse early decay.

Essentially, the difference between healthy teeth and tooth decay is a matter of balance and keeping the balance tipped toward health. That means controlling the factors that tip it toward health and away from disease. Here's a little about how it works:

Disease indicators, as the name implies, are indicators of disease. For example, the presence of white spots on the enamel of your teeth, early signs of decay, which can be detected by your dentist, your past experience of cavities, and whether you currently have tooth decay.

Today, with a “simple saliva sample,” we can test the bacteria in your mouth to determine your decay risk with a simple meter reading.

There are also certain risk factors for tooth decay that you can change by modifying what you do. The ways in which you can help yourself include:

• Reduce the amount of bacterial plaque (biofilm) build-up on your teeth. If plaque is actually visible on your teeth with the naked eye, it means there is a large amount that needs to be removed professionally. High levels of bacteria leave teeth more susceptible to attack from acid-producing bacteria that cause decay.
• Stop snacking on foods containing sugar between meals. Reducing the number of times your teeth are exposed to sugary snacks, and those that contain high amounts of refined carbohydrates, will help lower your risk of tooth decay. Stop feeding the bacteria sugar, which is turned into acid.
• Use fluoride toothpaste. This toothpaste will help strengthen your teeth, making them more resistant to acid attack. Deep grooves in the biting surfaces of your teeth, which we call pits and fissures, increase the likelihood of tooth decay making it impossible to reach with just a toothbrush. However, sealing these areas with “sealants” will prevent these areas from decaying.
• Always ask your doctors about the potential side effects of all medications. Certain drugs reduce the production of saliva and lead to dry mouth, which is one of the main contributors to tooth decay. Saliva has important buffering properties, neutralizing acids in the mouth, helping to reduce risk of decay.
• If you have an eating disorder, get professional help. People suffering from both bulimia and anorexia frequently vomit after meals, which creates a highly acidic condition in the mouth. Getting control over these conditions can help you also gain control over your risk for tooth decay.

We can further help assess your risk for tooth decay by using low dosage x-rays, microscopes, innovative laser technology, and other modern means. Call our office today to schedule a screening. To learn more about the diagnosis and prognosis of tooth decay, read the exclusive Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”

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.”

Quiz: What Is Smile Design?

All cultures worldwide recognize a smile as positive nonverbal communication. Yet many people are insecure about the way their smile looks. Modern cosmetic dentistry can completely change your smile through a comprehensive technique called Smile Design.

Take the following quiz to find out how much you know about your smile and smile design.

1. What is the basic reason we consider straight, healthy teeth to be attractive?
1. An article in a beauty magazine.
2. An instinctive understanding of health and survival.
3. Our first grade teacher said so.
4. A talk show on television.
2. What must we take into account in designing an attractive, balanced smile?
1. The shape of your face.
2. Your skin color and complexion.
3. The form of your lips.
4. All of the above.
3. As your dentist, we consider each of the following in evaluating your current smile except:
1. Your marital status.
2. The health of your bone and gum tissues.
3. How your jaw joints function.
4. The stability of your bite.
4. What do we use to evaluate your smile?
1. X-rays and photographs.
2. Models of your teeth and gums.
3. Photographs and computer graphics.
4. All of the above.
5. Bonding is one method that may be used to test or enhance your smile. It is used as:
1. A way of making friends with your dentist.
2. A way of training secret agents.
3. A method of repairing chipped, broken or decayed teeth and testing changes before they are made permanent.
4. None of the above.

Answers

1. b. What we consider an attractive smile is rooted in instinctive understanding of health and survival. We value straight, white, healthy teeth — only a few centuries ago, a person with few or no teeth was likely to starve.
2. d. All of these factors must be taken into consideration in order to design a smile that is in balance with your face.
3. a. While satisfaction with your life partner may make you smile, our priority in smile design is to make sure that the basic structures of your teeth are healthy and function properly.
4. d. All of the above are used in evaluating your current condition to design a new smile.
5. c. In bonding, a composite resin tooth colored material is shaped and physically bonded to a tooth or teeth that are chipped, broken, or decayed to restore both aesthetics and function.

After careful analysis and planning, a variety of techniques can be used to redesign an attractive and healthy new smile, so you can feel confident about smiling and sharing it with the world. To learn more about Smile Design, read “Beautiful Smiles by Design.” Or contact us to discuss your questions or to schedule an appointment.

If you believe you need a crown or if we have already confirmed this fact, you need to understand that there are several options. The most common are gold crowns, porcelain-fused-to-metal crowns and all porcelain crowns. Each has both pros and cons; thus we will work with you to determine which will work best for your specific needs. However, to help you learn more now, here are some facts.

Gold Crowns

Made from cast gold, this type of crown has been around for over 100 years and is the most successful type of crown. It can last more than 50 years and thus many dentists prefer gold restorations for their own teeth, where cosmetics is not a concern.

All Porcelain Crowns

All porcelain crowns can produce an incredible, life-like appearance. However, because they are made purely from dental porcelain (a type of glass), they tend to be more fragile than gold crowns and may be more at risk with certain high biting forces. Thus they may not be as durable. Porcelain can also cause wear to the natural teeth they bite against. Therefore they are typically preferred for front teeth, rather than back teeth. They have an aesthetic longevity of about 10 years and a functional longevity of about 20 years.

Porcelain-Fused-To-Metal Crowns

As the name states, porcelain-fused-to-metal (PFM) crowns provide the best of both worlds. They are made of natural tooth-colored dental porcelain that is fused on top of a precious or noble metal (usually gold or platinum). They are stronger than porcelain alone and are a good option for back teeth because they offer a better cosmetic result than gold crowns. This is also true for front teeth, however the gold support beneath the porcelain can compromise its life-like qualities. These crowns also have a proven track record and have been used with excellent results for over 40 years.

Learn more about crowns when you read, “Gold or Porcelain Crowns.” Or you can contact us today to discuss your questions or to schedule a consultation.

If you suffer from snoring or think you may have Obstructive Sleep Apnea (OSA), did you know that your dentist could play an important role in treating your condition? For most people this is surprising; however, we can provide both education and some treatment options. And as needed, we will work with your other healthcare professionals to get an accurate diagnosis so that you can improve both your sleep and your health.

Oral Appliance Therapy: These devices may look like orthodontic retainers or sports mouthguards, but they are designed to maintain an open, unobstructed, upper airway (tissues at the back of your throat) during sleep. There are many different oral appliances available but less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. Depending on your specific condition, we may use it alone or in combination with other means of treating your OSA. Here’s how they work. They reposition the lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize the lower jaw and tongue; and increase the muscle tone of the tongue — unblocking the airway.

Continuous Positive Airway Pressure (CPAP): CPAP bedside machines generate pressurized air delivered through a tube connected to a mask covering the nose and sometimes mouth. Pressurized air opens the airway (windpipe) in the same manner as blowing into a balloon; when air is blown in, the balloon opens and gets wider. This treatment option is generally not used for snoring, but rather for the more serious condition, OSA.

Surgery: Specially trained oral and maxillofacial surgeons may include more complex jaw advancement surgeries. Additionally, an Ear, Nose & Throat (ENT) specialist (otolaryngologist) may consider surgery to remove excess tissues in the throat. It also may be necessary to remove the tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate.

The first step towards getting a great night's sleep if you are a snorer that has never been diagnosed or treated for your condition is to obtain a thorough examination by a physician specifically trained in diagnosing and treating sleep disorders. And depending on the seriousness of your condition, he or she may strongly encourage you to participate in a sleep study. The results from this “study” can provide your dentist and other healthcare professionals with precise data about your snoring, breathing and sleeping habits. This information is key to treating OSA, if you are in fact diagnosed with this condition. Learn more when you read, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

The embarrassment of having discolored and/or stained teeth can be monumental and negatively impact your love life, work career, interactions with others, on top of undermining your self-esteem. And it is this reality that urges many people to wonder what teeth whitening could do for their specific needs. However, before obtaining any “fix,” you really should get an understanding of what causes staining of your teeth. This important step will enable you to make the necessary lifestyle and behavioral changes to prevent future issues.

For example, letting us know which of the following common causes for staining teeth apply to you can be an excellent first step towards building an optimal action plan for brightening your smile.

Which of the following questions about discolored teeth apply to you?

• Staining from tobacco use?
• Staining from coffee, tea and/or wine?
• Your teeth have become progressively discolored and yellow with age?
• Staining from red (tomato-based) sauces, sodas/colas and blueberries among other things?
• Other family members have stained teeth so it seems to be genetic?
• Staining from medications such as the antibiotic tetracycline given as a child?

Your honest responses to the above, along with your medical history will enable us to formulate the appropriate therapy for brightening your smile. And for most people this includes bleaching, an inexpensive yet effective method for whitening teeth. It is most often accomplished using a gel that is between 15% and 35% carbamide peroxide, a type of hydrogen peroxide. Years of research have proven that this whitening agent does not damage tooth enamel or the nerves inside the teeth. The only side effect that some people experience is slight tooth sensitivity and irritation of the gum tissues. However, they both are usually temporary, often occuring when you first start bleaching and generally subside after a few days. You can learn more when you continue reading the Dear Doctor article, “Tooth Staining.” Or, you can contact us to discuss your questions or to schedule an appointment.

Did you know that recent research has shown diabetes is a risk factor for increased severity of periodontal (gum) disease and that periodontitis is a risk factor for worsening blood glucose (sugar) control in people with diabetes? Periodontitis can even increase the risk of diabetic complications for people diagnosed with diabetes. When you combine these facts with the following, you will clearly see how important it is to understand and manage these two diseases.

• Over 23 million people in the United States currently have diabetes and over 170 million worldwide.
• 14+ million Americans have a condition called pre-diabetes.
• Another estimated 6 million people in the US have diabetes but are unaware and thus not diagnosed.
• Periodontal disease is the second most common disease known to man, only surpassed by tooth decay.
• Diabetic individuals with periodontal disease have a greater risk for cardiovascular and kidney complications than those diabetics not having periodontal disease.

What You Can Do

One of the most important steps you can take if you have either of these conditions or suspect that you might have one or both is to make an appointment with your physician or with our office for a thorough examination. You should schedule an appointment with your physician for an exam and blood work so that your general health and well-being are monitored. Be certain to share your medical information and any family history of diabetes with our office, as it tends to occur in families.

Learn More

Learn the risks and how to take care of types 1 and 2 diabetes, as well as the stages of periodontal disease (with detailed full-color illustrations) when you read the Dear Doctor article, “Diabetes & Periodontal Disease.” Or if you want to schedule an appointment to discuss your questions, contact us today.

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.

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.

In a recent online poll conducted by Dear Doctor, the premier oral healthcare resource for consumers, 77% of those polled planned on visiting their dentist prior to their wedding. For some, this includes a thorough cleaning to remove stains and freshen both their smile and breath. However, a growing number of brides, grooms, and parents of the couple are seeking cosmetic dentistry or more specifically, a smile makeover, to transform their smile for their special day as well as their future.

If this describes your situation, take the first step towards the smile you have always wanted. To create your ideal smile, we will first meet with you to get to know you better and hear your concerns, goals, expectations and wedding day timeline. Bringing in photos or magazine images of smiles that you consider beautiful will help to ensure that we understand what you find attractive, as beauty can vary greatly from individual to individual. During this initial consultation, you will also learn about your smile makeover treatment options and what you could expect immediately prior, during and following each option.

Some subtle improvements we may consider are teeth whitening and bonding. Both of these options can take place in just a few office visits and produce very attractive results. Porcelain veneers and crowns can provide you with longer-term results that can last from 10 to 20 years. However, because they typically require 1 to 4 months advance notice, it is important to see us as soon as possible to ensure you have enough time before your special day. Another procedure that can play a dramatic role in your smile makeover is periodontal plastic surgery to improve and alter your gum tissues and their relationship to your teeth. For example, the appearance of “short” teeth can be corrected by lengthening them during a surgical procedure that has minor discomfort yet results in a life-long change.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”

Oral cancer is on the rise in the United States, yet few people are familiar with the disease and its risk factors. The National Institute of Dental and Craniofacial Research (NIDCR) estimates that 35,000 Americans are diagnosed with the disease each year. The good news is that prevention and early detection can greatly reduce your risk of developing oral cancer.

Risk Factors for Oral Cancer Include:

• Tobacco: Smoking and using chewing tobacco have been shown to increase the risk of developing oral cancer.
• HPV virus: The Human Papilloma Virus (HPV) is the same virus linked to cervical cancer and genital warts. According to the Oral Cancer Foundation (OCF), many young people and women are being diagnosed with oral cancer as a result of exposure to the HPV virus.
• Age: Although it occurs more frequently in people over the age of 40, the incidence is increasing in younger people.
• Alcohol Consumption: Oral cancer is six times more common in those who drink alcohol excessively.
• Diet: People who consume lots of red and processed meat and fried foods are at greater risk.

Symptoms: Alert our office if you notice a change in your mouth such as a sore that doesn't heal or bleeds easily; a lump, thickening, crust or erosion; pain or tenderness; or a change in the way your teeth are positioned. Our office can administer an easy, painless test that detects abnormal cells.

Other symptoms may include unexplained bleeding or numbness in the mouth, difficulty chewing, swallowing or speaking, hoarseness, chronic sore throat or changes in your voice.

Importance of Dental Screenings: In its early stages, oral cancer can often go unnoticed, but visiting our office regularly can ensure that any cancerous cells are detected and treated early. Our office will check your tongue and the area under your tongue, as well as your lips and palate and the back of your mouth.

Contact us today to schedule an appointment to discuss any questions that you may have regarding oral cancer. Read more about this topic in the Dear Doctor magazine article “Oral Cancer: This Article May Save Your Life.”

Gum or periodontal disease is a condition in which “biofilms” or dental bacterial plaque sticks to teeth around the gum line in the absence of good oral hygiene. If left untreated, it causes inflammation of the gums and surrounding tissues of the teeth that can result in “pocketing,” gum recession and bone loss that eventually leads to loose teeth, followed by no teeth! And for about 10 to 15% of those having gingivitis or stage 1 periodontal disease, it can get worse by progressing into chronic periodontal disease. However, the good news is that a conservative and simple treatment called root planing combined with good daily oral hygiene may return your gum tissues to health, and even eliminate the need for gum surgery.

Most of the time, root planing is performed with local anesthesia (numbing shots) in the areas requiring treatment. Anesthesia is an important part because you should always feel relaxed and comfortable during treatment. Because inflamed gum tissues may be quite sensitive, these numbing shots enable us to accomplish our goals and thoroughly remove the problematic material from your teeth's roots.

Root planing or deep cleaning is a routine dental procedure usually done in conjunction with scaling, the removal of the more superficial deposits on the tooth surfaces. Root planing involves physically planing (scraping) the root surfaces of the teeth to remove calculus, bacteria and toxins that are ingrained into their surfaces so that the attached gum tissues can heal. It is carried out with manual hand instruments, ultrasonic electronic instruments or a combination of both for your comfort and best results.

You can learn more about this procedure by reading, “Root Planing.” Or if you want to schedule an appointment to discuss your questions, contact us today.

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.”

Cleaning dentures is an important part of wearing them. However, did you know that recent research has revealed a link between denture hygiene and overall health? The evidence shows that oral bacteria have been implicated in chronic obstructive pulmonary (lung) disease, bacterial endocarditis (“endo” – inside; “card” – heart), generalized infections of the respiratory tract and other systemic diseases. While it is never our intent to frighten you, we feel it is important that we share some important tips on maintaining and caring for your dentures so that your oral health does not negatively impact your general health.

Our first tip focuses on fit, as denture slippage is an experience that anyone who wears dentures dreads. So if your dentures seem to slip or you have started increasing the amount of adhesive you are using to achieve the same level of denture retention that you had when first fitted, you need to make an appointment with us soon. Otherwise, an ill-fitting denture can cause discomfort, embarrassment and contribute to other oral health issues.

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.”

Describing Vanna White, co-host of the hit television game show Wheel of Fortune as friendly is an understatement. Yes, a good portion of the credit goes to her bubbly personality; however, you can't look at her without noticing her world-famous smile.

During an interview with Dear Doctor magazine, Vanna shared some of the secrets to her trademark smile. Secrets that she is instilling in her children.

“I floss every day and I brush my teeth at least twice a day — morning and night — and sometimes after lunch.” She added, “I think that flossing is the most important thing. I believe that dental floss helps a lot, as it keeps your gums strong and looking younger.” And when asked about how often she has her teeth professionally cleaned she replied, “...every four to five months because I get a lot of plaque buildup.”

A typical dental hygiene visit is one that involves prophylaxis, a dental (and insurance) term for scaling and or polishing procedures to remove plaque and calculus (tartar) from the crown or portion of the tooth that you can see. Scaling is a procedure where we use special hand-held instruments and/or ultrasonic scalers to remove plaque, bacteria and tartar that can coat your teeth causing them to feel rough or fuzzy. To polish your teeth, we use a rubber polishing cup, prophy paste and a motorized instrument that removes bacterial plaque and surface stains. This is usually the last portion of a routine cleaning because it leaves your teeth feeling smooth and shiny.

However, if you have been seeing blood when you brush your teeth or while flossing, you have the telltale signs of periodontal (gum) disease. During your cleaning appointment, we will clean below the gum line to treat and manage your periodontal disease (an infection of the gum and jaw bones). We may also discover that additional, deep-cleaning treatments (such as root planing) may be needed to treat and manage your periodontal disease.

To learn more about this topic, continue reading the Dear Doctor magazine article “Teeth Polishing.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and cleaning. And if you want to read the entire feature article on Vanna White, continue reading “Vanna White.”

Cat Cora, philanthropist, author, chef, restaurateur and the first female chef on the Food Network's hit series Iron Chef America is a dynamo driven by a desire to change people's lives for the better. And she is no different when it comes to tackling her most challenging role: caring for the needs of her four active young sons. This includes monitoring the food they eat, their oral hygiene habits and protecting their teeth from injuries.

During an interview with Dear Doctor magazine, Cat describes a backyard accident in which one of her boys, Zoran, was accidentally knocked in the mouth by another child while jumping on the family's trampoline. While her son was not seriously injured, it did cause her to take proactive steps to avoid future injuries. She had her dentist make a custom-fitted mouthguard to protect his newly erupted adult teeth. He now wears the mouthguard while on the trampoline and when playing soccer.

If you and/or your children routinely participate in contact sports — boxing, football, hockey, lacrosse, soccer, water polo, rugby and basketball, for example — or other forms of vigorous physical activity, you too should consider getting a professionally made mouthguard. A properly fitted mouthguard can help prevent injuries to the jaws, lips and teeth. And unlike those cumbersome “boil and bite” mouthguards you can purchase at a drugstore, the ones we make will stay in place, making it easier for you to breathe and talk.

If you are still not convinced, consider these facts: According to the American Dental Association, an athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard. And 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. Furthermore, 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.

To learn more about mouthguards, continue reading the Dear Doctor magazine article “Mouthguards.” Or if you are interested in obtaining a mouthguard for yourself and/or your child, contact us today to schedule an appointment. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”

Florence Henderson, star of one of television's most beloved situation comedies, is still actively engaged in a variety of projects at 75-plus years of age. Her bright smile was part of her character as Carol Brady in The Brady Bunch, a popular sitcom that played for five seasons from 1969 to 1974. Though the show was discontinued, syndicated episodes continue to play in the U.S. and 122 other countries.

“I played Carol as the mother I always wished I had,” she told Dear Doctor magazine. Her portrayal of mother and wife in a blended family with six children won her the Smithsonian Institution's TV Land Pop Culture Icon Award, which is on display in the National Museum of American History in Washington, DC.

After her successes on Broadway and in television, she was selected for numerous product endorsements, and The Wall Street Journal ranked her #5 in their top ten television endorsers based on viewer satisfaction. One of the products she endorsed was Polident, a brand of denture cleaners and adhesives. However, Henderson has revealed that she has her own natural teeth and does not wear dentures. Her advice to others who want to keep their natural teeth is to pay attention to prevention. “I think the most important thing one can do as with any health issue is prevention,” she said. “Flossing, brushing, and regular dental checkups are vitally important if you want to keep your natural teeth.”

When she was 22, she says, she had four impacted wisdom teeth removed at the same time. This experience made her aware of the importance of dental care, and since then she has had a checkup every six months. Wherever she travels, she says that she always has mouthwash, dental floss, toothpaste, and a toothbrush on the set.

Contact us today to schedule an appointment to discuss your questions about tooth care. You can learn more about Florence Henderson by reading the Dear Doctor magazine interview “Florence Henderson, America's Favorite TV Mom Has Many Reasons to Smile.”

As America's toughest trainer on the hit television program The Biggest Loser, Jillian Michaels helped people learn that they hold the power to change. And if anyone knows about the power of changing oneself, it is Jillian Michaels. In her recent interview with Dear Doctor magazine, Jillian discusses her childhood, the trauma of being overweight as a teenager (5' 2" and 175 pounds), and the day her life forever changed when she started martial arts training at a gym. “I started training when I was 17 and always loved it but never thought it would end up being my career,” she said.

Jillian also reveals that when she was a child, she broke her two front teeth and had them repaired with crowns. She added, “Now, I generally wear a mouthguard if I am doing anything where my teeth have any chance of being knocked out.”

When it comes to replacing teeth that are broken or damaged from trauma, or teeth that are damaged because of dental decay, grinding habits, or acid erosion, crowns may be your best option. And because the tooth enamel is damaged, a bit more of it must be removed before we can place a crown. Generally speaking, we must remove about 2 millimeters of tooth structure to place a crown. Once the crown is placed, the tooth will always require a crown, as this is an irreversible procedure. However, the good news is that a crown not only mimics the look and feel of a natural tooth, but it is also the optimal long-term solution. On average, a crown last between 5 and 15 years and requires no special maintenance. In fact, you should treat your crown as you do your natural teeth, with a daily cleaning regimen of brushing and flossing and routine dental examinations and cleanings.

To learn more about crowns or other cosmetic procedures, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you. Or to learn more about crowns now, you can continue reading the Dear Doctor magazine article “Porcelain Crowns & Veneers.” And to read the entire interview with Jillian Michaels, please see the article “Jillian Michaels.”

When you say “ahhhhh,” are you worried about all your unsightly metal fillings? If so, did you know that your dentist can resolve your concerns through the use of tooth-colored fillings?

The public's demand for aesthetic tooth-colored (metal free) restorations (fillings) together with the dental profession's desire to preserve as much natural tooth structure as possible has led to the development of special adhesive tooth-colored restorations. And the demand is not limited to just the front teeth. In fact, many people are opting to replace all of their metal fillings — not just those in the front teeth — so that all of their teeth appear younger, fresher and as if they have never had any cavities.

Can you really mimic natural teeth? Proper tooth restoration is a lot more than just filling holes. It is a unique art applied with scientific understanding. Each tooth's internal shape and structure is the guide to how it must be rebuilt to successfully restore it. However, choosing which material to use to restore or rebuild teeth is a critical one based on scientific understanding, experience and clinical judgment — expertise we use daily in our office. The most popular options include composite resins and porcelains, as they allow us to mimic natural tooth colors and shapes. But for the most life-like, natural tooth-colored filling, your best option is porcelain. Porcelain, which is built up in layers, can be made to mimic the natural translucency and contours of tooth enamel.

But what about matching the color? Will it really match? Absolutely! Whether we use resins or porcelain, through our artistry we will create absolute tooth-like replicas. You will never know your teeth have fillings! And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, thus stabilizing and strengthening them. These techniques are even suitable for children's teeth and can incorporate fluoride to reduce decay.

Still undecided? If so, we understand. Feel free to contact us today to schedule an appointment to discuss your questions about tooth-colored restorations. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”

FAQs About This New and Miraculous Procedure

How can sinus surgery contribute to the replacement of missing back teeth with dental implants?
Dental implants must be anchored the in bone to be successful. Maxillary sinus surgery can help regenerate bone that has been lost and is critically needed to anchor dental implants.

What are the maxillary air sinuses?
Inside the upper jaw, or “maxilla,” are structures known as the maxillary air sinuses, one on either side of the upper jaw. Each sinus is an air-filled space lined by a membrane. Upper back teeth are normally encased in the bone of the maxilla, below the sinuses.

Why is it important to replace missing back teeth?
Replacing back teeth restores the ability to eat, chew, and talk properly. The back teeth also provide facial and cheek support.

Why use dental implants?
Dental implants are the state-of-the-art method for replacing missing teeth.

Why does bone loss occur?
Unless special precautions are taken to prevent it, when teeth are lost, the bone supporting them is also lost.

If there is insufficient bone to anchor dental implants, what are the alternatives?
If all the back teeth are lost and dental implants cannot be placed, removable upper dentures may be the only alternative.

How do you determine whether a sinus surgical procedure is necessary?
The size, shape, and remaining bone of the maxillary sinuses influence whether you can have dental implants with or without a sinus surgical procedure.

How does surgery grow bone?
A small window is created in the sinus wall above where implants need to be placed. The sinus membrane is lifted and the space thus created filled with bone grafting and biologically active bone generating materials. The window is then closed and simply heals.

How is the surgery done?
The surgical procedures are performed from inside the mouth in the area just above the missing back teeth. They are generally carried out under local anesthesia (small shots, just like for a filling), sometimes with the addition of sedation or anti-anxiety medication.

How do bone grafts work?
Bone grafts act as scaffolds that the body replaces with its own bone. The most well researched bone substitute grafting material is currently bovine (cow) bone. All grafting materials are approved by the Food and Drug Administration. They are specially treated to render them completely sterile, non-contagious, and free of rejection factors.

What can I expect after surgery?
Moderate swelling and discomfort after surgery generally lasts for a few days to a week, about the same as having an upper impacted wisdom tooth removed. Supportive treatment usually includes a course of antibiotics to prevent infection and prescription strength medication of the aspirin or ibuprofen type. A decongestant may also be prescribed, if necessary. Healing is generally uneventful.

Who performs this surgery?
Maxillary sinus augmentations are usually carried out by oral surgeons, periodontists, or appropriately trained general dentists. Proper assessment of your situation and diagnosis are critical pre-requisites to the right procedure.

If you are missing upper back teeth, contact us today to schedule an appointment and discuss maxillary sinus augmentation. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery: Creating Bone for Dental Implants out of Thin Air.”

A dental crown is a tooth-shaped “cap” or cover that we place over a tooth that is badly damaged from trauma or decay to restore its shape, strength, size and functionality. We also use them for cosmetic reasons to improve a tooth's appearance with natural, life-like results. Crowns are generally handcrafted by dental laboratory technicians using high-quality dental porcelains (ceramic materials) that are made to fit on precise replicas (molds) of the prepared teeth. In our office, we generally make temporary crowns to protect the teeth to keep them comfortable and functional while the permanent crown(s) is being made. And once a crown is placed (cemented into position), it fully encases the entire visible portion of the tooth that lies at and above the gum line.

When Are They Necessary?

There are many reasons a crown may be needed. Some of these include:

• To repair a tooth that is worn down, broken or badly damaged by decay or injury.
• To restore a tooth so severely damaged by decay that the tooth's structure is no longer intact enough to place a filling or where a filling can't restore the tooth to its former strength.
• To protect a tooth that has minor cracks or fractures from further damage.
• To create a bridge to replace a missing tooth, in which the teeth on either side, known as abutments, must be “crowned” to attach to the “pontic” (from the French word, “pont” that means bridge).
• To create the visible part of the tooth that sits atop a dental implant.
• To improve the appearance of a tooth providing a more appealing shape and color.

To learn more on this topic, read the Dear Doctor article, “Porcelain Crowns & Veneers.” You can also contact us to discuss your questions or to schedule a consultation.

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.”

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!”

Witnessing or being involved in a sports-related dental injury can be a scary event not only for the player, but also for onlookers even if the injuries turn out to be minor. However, knowing what to do — and more importantly — how quickly to react can make a radical difference to the outcome. This is just one reason why we want to share the following easy-to-remember guidelines for what, how and when you need to respond to various types of dental injuries.

• Immediate — within 5 minutes of the injury: If a permanent tooth is totally knocked out (avulsed), it requires immediate treatment by cleaning and re-implanting the tooth back into its original position to have any hope of saving the tooth long-term. Knocked out baby (primary) teeth are not reimplanted for fear of damage to underlying permanent teeth.
• Urgent — within 6 hours of the injury: If a permanent or primary tooth is still in the mouth but has been moved from its original position, it is considered an acute injury and should be treated within 6 hours.
• Less urgent — within 12 hours of the injury: If a permanent or primary tooth is broken or chipped but has not shifted from its original position, the injury is classified as less urgent. You still need to see a dentist for an exam; however, you generally can wait up to 12 hours before possible irreversible damage occurs.

Want To Learn More?

There are several ways you can learn more about sports-related dental injuries.

• Read the Dear Doctor article, “The Field-Side Guide To Dental Injuries.”
• Download and print the FREE quick reference guide
• 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.
]]>Sat, 03 Mar 2012 04:18:56 -0600http://www.drshenk.com/blog/post/eight-reasons-to-take-good-care-of-your-teeth-when-pregnant.html

A pregnant woman has a lot to think about while preparing to welcome a new member of her family. It's important to think about her oral health as well. She is sharing her body with the developing infant, so problems with her health — including her dental health — can affect the baby. The following facts will help you understand the relationship between oral health and pregnancy.

1. A baby's primary (baby) teeth begin to form during the sixth week of pregnancy. They begin to form their enamel (the hard outer layer of the teeth) and dentin layer (just under the enamel) at about the third or fourth month. The calcium, phosphorous, and protein that are needed for these structures must all be provided by the mother's diet.
2. A good diet for a pregnant mother, in order to provide for both her needs and those of the fetus (the developing baby), includes whole grains, fruits, vegetables — including green leafy vegetables — proteins and dairy products. A doctor may also recommend iron and/or folic acid supplements.
3. If the mother's diet does not provide enough calcium for the baby's bones and teeth, it will come from calcium stored in her bones — not from her teeth. The old idea that a mother's teeth lose calcium during pregnancy has been found to be a myth.
4. Progesterone, a normal female hormone, is elevated during pregnancy. This hormone stimulates production of prostaglandins, substances that cause inflammation in gum tissues if the bacteria that cause periodontal (gum) disease are present. The resulting swelling, redness, and sensitive gum tissues, called pregnancy gingivitis, are common during the second to eighth months of pregnancy.
5. The bacteria involved in periodontal disease can affect whole body conditions such as heart disease and strokes, diabetes, and respiratory diseases. The inflammation resulting from such bacteria can also cause premature delivery (birth before 37 weeks of pregnancy) or low birth weight in the baby.
6. Periodontal disease is also related to pre-eclampsia, or high blood pressure, during pregnancy.
7. Dental x-rays do not expose the mother to very high radiation, but in any case every precaution is taken to minimize exposure to the fetus. These include a leaded apron that shields the baby from exposure.
8. Most drugs commonly used in dentistry, including local anesthetics, can safely be given to pregnant women without affecting the fetus. However, it is important to let your dentist know you are pregnant before embarking on any treatment to make sure anything that is done will be safe for the fetus and its developing teeth.

Contact us today to schedule an appointment to discuss your questions about pregnancy and your oral health. You can also learn more by reading the Dear Doctor magazine article “Pregnancy and Oral Health.”

]]>Sun, 11 Mar 2012 04:22:53 -0500http://www.drshenk.com/blog/post/facts-you-should-know-about-tooth-wear.html

You may have noticed, as you get older, that the enamel of your teeth is looking worn in certain areas. Sometimes tooth wear takes the form of a minor chipping or fracturing at the incisal (cutting) edges of the teeth, or a loss of tooth material from the area near the gum line. In more severe cases, worn teeth look quite a bit smaller than they used to. Why does this happen?

Some wear with age is natural. But too much wear can interfere with your bite, expose more sensitive inner parts of the tooth to decay, and give you a more aged appearance.

There are things you can control that affect wear:

Your habits: Clenching or grinding habits, also called “bruxism,” is a major cause of tooth wear. The motion of teeth sliding over each other with forces that are beyond what's normal for biting or chewing causes a mechanical removal of tooth enamel. This can happen during sleep or periods of high stress. In either case there are therapies available, such as a thin, professionally made mouthguard that prevents your teeth from coming into contact with each other. Holding foreign objects, such as nails and bobby pins, between your teeth can also cause wear.

Your diet: Tooth enamel can be eroded (dissolved away) by acidic beverages, such as sodas, sports drinks and juices. Frequent snacking on sugary foods encourages the growth of oral bacteria that produce acid as a byproduct — also leaving your teeth vulnerable to tooth decay. Your saliva can buffer the effects of the acid in your mouth in about half an hour; if you consume these types of foods and beverages continually, there won't be enough time for this to work.

We can restore the appearance and function of worn teeth in a variety of ways. Porcelain crowns and veneers, for example, can re-establish the normal thickness and length of teeth while improving their color and giving you a more youthful appearance.

If you have any questions about tooth wear, please contact us today to schedule an appointment for a consultation. You can learn more about tooth wear by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

]]>Mon, 19 Mar 2012 04:21:45 -0500http://www.drshenk.com/blog/post/dont-like-the-drill-now-theres-drill-free-cosmetic-dentistry.html

If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.

Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.

Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.

Advantages of prepless veneers include:


• Tooth preparation or reduction is not needed, leaving the original tooth whole.
• They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
• They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
• They can be used to “lengthen” teeth that have been worn down by grinding.
• Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.

Disadvantages include:


• There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
• Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
• Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
• They do not usually work for lower teeth because of space restrictions.
• They cannot replace lost or damaged enamel.

Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.

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

]]>Tue, 27 Mar 2012 04:10:57 -0500http://www.drshenk.com/blog/post/root-canal-treatment-for-primary-baby-teeth.html

If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.

When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.

If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.

If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.

When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.

Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.

Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”

]]>Wed, 04 Apr 2012 04:23:14 -0500http://www.drshenk.com/blog/post/understanding-the-basics-of-laser-dentistry.html

For many people, when they hear the term “laser,” they immediately envision a futuristic science fiction movie. However, did you know that lasers have been used in the medical industry for years? Furthermore, this revolutionary technology is now beginning to do the same within the field of dentistry.

Lasers get their name from “Light Amplification by Stimulated Emission of Radiation” and are literally beams of light that have a single wavelength. Unlike traditional white light or daylight that is a continuum of light with many wavelengths corresponding to the visible spectrum or rainbow, a laser light beam is just a single color.

Dental laser usage typically falls into three categories: disease diagnosis; soft tissue procedures of the gums, lips, and tongue; and hard tissue procedures of the bone or tooth enamel and dentin. For example, common uses include diagnosing cavities, treating disease, and removing both diseased gum tissues and tooth structure, as in decay. They were first used in dentistry for soft tissue surgery such as gum line reshaping procedures and tissue testing (biopsies). In 1997, dentists started using them for removing decay and preparing the tooth enamel and dentin in preparation for fillings. More recently, dentists are using lasers to help detect and diagnose dental disease, as they are especially helpful in identifying dysplastic (“dys” – altered; “plasia” – growth) or precancerous tissue as well as cancerous tissues. Thus they have been used for removing both malignant (cancerous) and benign (non-cancerous) lesions in some cases.

As you now see, laser dentistry is an important tool we use at our office to provide our patients with optimal dental care and treatments. And if you want to learn more about laser dentistry, read the article “Lasers Shine A Light On Dentistry.” Or if you want to schedule an appointment to see if laser dentistry is right for you, contact us today.

]]>Thu, 12 Apr 2012 04:43:58 -0500http://www.drshenk.com/blog/post/important-warning-signs-of-gum-disease.html

Periodontal or gum disease is an often silent disease that can cause significant damage to the health of your teeth and body. The reason it is so often classified as a silent disease is because it is chronic or longstanding and often without any symptoms or pain that most people associate with a disease until it may be too late.

If you think you may have gum disease, here is what to look for:

• Bleeding gums — probably one of the most common and overlooked early warning signs that most people ignore is thinking that the bleeding is being caused by brushing their teeth too hard. The truth is that you would have to brush extremely hard to cause healthy gum tissues to bleed.
• Bad breath — something everyone has experienced; however, it can also be a warning sign of periodontal disease. This is especially true for people who hate or refuse to floss their teeth, thereby trapping literally billions of bacteria where they love to collect in the protected areas between the teeth.
• Redness, swelling, and/or receding gums — all signs of gum disease often accompanied by sensitivity of the gum tissues around the teeth.
• Chronic inflammation — long-standing gum inflammation is a sign that your gum tissues are not healing properly. Periodontal disease exhibits periods with bursts of activity followed by periods where the body tries to recover.
• Loose and/or moving teeth — that seem to be drifting into a new position, are visible signs that you are highly likely to have periodontal disease.
• Abscess formation — late stage gum disease is characterized by painful, swollen, red pockets of pus, which denotes an acute localized periodontal infection.

If you have any of these signs, you need to make an appointment for a thorough evaluation. Otherwise, you could end up losing your teeth to the second most common disease known to man after tooth decay. To learn more about gum disease, continue reading, “Warning Signs of Periodontal (Gum) Disease.” Or, contact us today to schedule an appointment.

]]>Fri, 20 Apr 2012 04:16:16 -0500http://www.drshenk.com/blog/post/the-importance-of-mouthguards---do-you-know-the-facts.html

Just as you would expect, we highly recommend the use of protective mouthguards to anyone participating in contact sports or rigorous physical exercise. The primary reasons we feel this way are substantiated by evidence-based research and experience within our practice. If you don't think mouthguards are helpful, here are some facts you should know:

• Research conducted by the American Dental Association (ADA) found that individuals are 60 times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise. This shocking fact alone illustrates the importance of protective mouthguards.
• A study reported by the American Academy of General Dentistry (AAGD) found that mouthguards prevent more than 200,000 injuries to the mouth and/or teeth each year.
• Sports-related injuries often end-up in the emergency room; however, the US Centers for Disease Control (CDC) reports that more than 600,000 of these visits involve injury or damage to the teeth and mouth.
• In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending $10,000 to $20,000 per tooth over a lifetime for teeth that are not properly preserved and replanted. This staggering statistic is from the National Youth Sports Foundation for Safety.
• While protective mouthguards were first used in the sport of boxing during the 1920s, the ADA now recommends their use in 29 (and growing) different high contact sports and activities. Some of these include acrobatics, baseball, basketball, bicycling, field hockey, football, handball, ice hockey, lacrosse, martial arts, skateboarding, skiing, soccer, softball, volleyball and wrestling.
• It used to be that only males were considered when it came to needing mouthguards. However, recent studies have revealed that the growing interest and participation of females in these same sports and activities makes it just as important for them to protect their teeth.

To learn more about the importance of mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards.” You can also contact us today to schedule an appointment or to discuss your questions about protecting your mouth and teeth. And if you have already suffered from a dental injury, let us evaluate the damage and work with you to restore the health and beauty of your teeth.

]]>Sat, 28 Apr 2012 04:21:56 -0500http://www.drshenk.com/blog/post/veneers-not-just-for-woodworking.html

You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.

Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.

In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.

Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.

Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.

Contact us today to schedule an appointment to discuss your questions about porcelain veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

]]>Sun, 06 May 2012 04:20:28 -0500http://www.drshenk.com/blog/post/learn-the-signs-of-periodontal-disease.html

Periodontal (gum) diseases are sometimes called “silent” because those who have them may not experience painful symptoms. But certain signs point to the existence of these common diseases. If you are experiencing any of the symptoms below, it is time to visit our office so these problems can be treated before they lead to serious infection and loss of teeth.

Gums that bleed during the brushing of teeth. Some people think that gums bleed from brushing too hard. In fact, healthy gum tissues will not bleed with normal brushing. The usual cause of bleeding gums is an accumulation of dental plaque in the areas where your teeth meet your gums. Plaque is a film of bacteria, called a biofilm, which accumulates on your teeth. If you are not brushing and flossing effectively, plaque irritates your gum tissues and causes an inflammation and swelling called gingivitis. This causes your gums to bleed easily on contact with a toothbrush or floss.

Gum tissues that appear red and swollen. If plaque is allowed to accumulate for 24 hours or more, the inflammation in your gum tissues becomes chronic. The continuous presence of bacteria makes it impossible for your body's natural defenses to fight the infection. Chronic inflammation leads to a breakdown of the normal attachment between the teeth and the gums, causing the formation of “pockets.” Inside these pockets the infection continues to attack the tissues that support your teeth. Eventually this can lead to a breakdown of the bone that surrounds your teeth.

Bad breath. Bad breath is another sign of accumulated plaque. The bacteria in plaque may emit gases that have an unpleasant odor.

Gums that are sensitive to hot or cold. Chronic inflammation can also cause the gums to recede, exposing the roots of the teeth in which nerves may be close to the surface, leading to sensitivity to heat and cold.

Teeth that are getting loose, or a painful area in the gums. If you experience these symptoms, the infection has progressed a long way from the “silent” stage. It is time to seek immediate professional help.

If you answered “yes” to any of the above questions, a professional dental examination is in order. With daily removal of plaque by effective brushing and flossing, along with frequent professional cleanings to remove any plaque that you were unable to catch, you will go a long way to preventing periodontal disease. Also, be aware that smoking tends to mask the effects of gum disease. Generally, if you smoke your gums will not bleed when brushing or flossing, nor will they show signs of swelling.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine articles “Bleeding Gums” and “Warning Signs of Periodontal (Gum) Disease.”

]]>Mon, 14 May 2012 04:21:25 -0500http://www.drshenk.com/blog/post/include-a-smile-makeover-in-wedding-planning.html

For a bride, there is so much to remember when planning the wedding — invitations, a dress, flowers, the site, the caterers, the cake, the photographer — the list goes on and on. In the midst of all these things, don't let a very important piece of the plan be forgotten — your smile!

Your wedding will be celebrated every year on your anniversary and commemorated in beautiful photos at any time. It is a special occasion you, your family, and your friends will always remember. But how will you and your family look in those photos? You have an opportunity to get makeovers that will make your smiles shine radiantly, and not only in your album. Your makeover will improve your appearance, your self-confidence, and your oral health far into the future.

Start with a visit to your dentist to assess your current situation and discuss your goals and dreams. Each person's situation will be different. At a minimum you may need a professional cleaning to make sure that your teeth and gums are healthy. Get started on treating any cavities or gingivitis (gum inflammation). If you haven't already, now is a great time to establish healthy dental hygiene habits including proper daily brushing and flossing.

You may feel that your teeth are discolored and need to be whiter and brighter. Your upper and lower jaws may not meet properly for the most effective biting and chewing. Your teeth may be crowded or misshapen. All these things and more can be modified and repaired with today's dentistry.

Teeth can be whitened by bleaching in the dentist's office or with products that can be used at home under a dentist's supervision.

Orthodontia may be needed to repair your bite. Today orthodontia may be done either with traditional braces, or with clear aligners. Remember that this process works slowly, so start well in advance of your wedding day.

After your teeth are properly aligned, your dental team can work on subtle contouring, overall shape and color changes for individual teeth, using techniques such as porcelain laminate veneers. Temporary veneers can be made so that you can try out your new look before the final installation.

Wedding planning works best when started early. To make sure you, your new spouse, and your family look and feel their best, remember to include smile makeovers in your plan.

Contact us today to schedule an appointment to discuss your questions about wedding smile makeovers. You can also learn more by reading the Dear Doctor magazine article “Wedding Day Smiles.”

]]>Tue, 22 May 2012 04:19:34 -0500