Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”

Dental professionals agree that effective removal of plaque, the film of bacteria (also called a biofilm) that gathers on everyone's teeth, is the key to good dental health. Daily brushing and flossing are the usual recommendation for plaque removal. It is important to ask us about effective brushing and flossing. At your next appointment, ask us for a demonstration.

Effective brushing removes plaque from the easily accessed surfaces of the teeth. To remove plaque from between the teeth, you must floss.

Some people find it awkward to hold the floss with their fingers as they move it around their teeth. One technique for flossing, suggested by a dentist in Dear Doctor magazine, may make it easier than more traditional methods, although it does take a little practice.

Preparation
This method requires tearing off a 10 to 12 inch length of floss and tying it to form a circle big enough for your fingers, but not your thumbs, to fit within it. The circle should be knotted with a double knot.

To Clean Teeth and Gums
Keep the floss taut at all times, with about and inch or less between your thumb and index fingers for your upper teeth, or index fingers only for your lower teeth. Curve the floss around each tooth and gently move it up and down until you hear a squeaky clean sound. Extend the downward movement of the floss to just below the surface of the gum, without being too harsh and causing injury. As you move from tooth to tooth, move around the floss circle so that each tooth gets a clean section of floss.

Upper Teeth
Place all your fingers in the ring, with the floss over your left thumb and right index finger to floss your upper left teeth, and over your right thumb and left index finger to do the other side.

Lower Teeth
Use both index fingers to floss all your lower teeth.

You may only need to floss once a day before or after brushing to keep your gums health and ward off periodontal (gum) disease. Your dentist will guide you as to how often you may need to floss your teeth. Try this technique and see how it works for you.

Contact us today to schedule an appointment to discuss your questions about flossing techniques. You can also learn more by reading the Dear Doctor magazine article “Flossing — A Different Approach.”

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.”

Most people think of bone as rock-solid, but it's actually a living tissue that's constantly changing. This has significant implications for your oral health, general health, and appearance — if you are one of the 70% of Americans missing at least one tooth.

Throughout the day, your top and bottom teeth make hundreds of fleeting contacts with each other. These small stresses are transmitted though the periodontal ligament (“peri” – around; “odont” – tooth) that supports each tooth in its socket like a hammock. Think of it as a gentle push on the hammock, which causes the tooth to gently bump the underlying bone. The bone then builds up in the spot that's receiving stress to counteract it. This constant remodeling of bone is what allows bone to stay healthy and strong.

When a tooth is lost, the bone does not receive that gentle stress. It reacts by literally melting away. Sometimes this happens fairly quickly — in a matter of months. After the tooth-supporting bone is lost, the jawbone itself begins the same process of deterioration. This could eventually change the shape of the face, as the distance from nose to chin can decrease — even if only a few back teeth are missing. The results aren't pretty. But the good news is, there's a way to prevent all this.

Dental implants, which function as substitute tooth roots, actually save underlying bone when teeth are lost. They do this because they are made of titanium, which fuses to the bone in which it's set, stabilizing it. The implant is topped by a realistic-looking crown, which replaces the part of the missing tooth that was visible in the mouth. Together, they look and function just as your natural tooth did.

If you are missing a lot of teeth, implants can also be used to anchor bridges or even removable dentures while providing that same bone-saving benefit. And when you consider that they are so durable they should never need replacement, implants are a great investment.

If you have any questions about dental implants, please contact us, or schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

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.

Do you constantly feel like you are running on empty? Do you snore, feel like napping every day, or even drink multiple cups of coffee just for the caffeine boost? You may have a sleep related breathing disorder (SRBD) or Sleep Apnea (“a” – without; “pnea” – breath) in which your airways become obstructed causing chronic loud snoring. The good news is that we can help both diagnose and treat this disorder, which means you will be able to finally get the rest that you (and your sleeping partner) so desperately need.

The reason that sleep apnea is so disruptive to daily living is that it causes awakening for a few seconds up to 50 times per night, significantly decreasing the amount of deep sleep that is necessary for full rejuvenation. Airway blockage during sleep commonly results from obesity, an enlarged tongue or tonsils, and other factors that can cause your airway to close off when you lie down, all increasing the likelihood that you will suffer from sleep apnea. These conditions are dangerous and impair the brain and heart from receiving adequate oxygen, increasing your risk for both stroke and heart attack.

The study of sleep and its disorders is relatively new. One successful way to treat sleep apnea is with a “CPAP” machine which uses a Continuous Positive Airway Pressure mask overnight to keep air passages open while sleeping. Another more comfortable, less noisy, and unobtrusive method is to use Oral Appliance Therapy, which features an appliance like a retainer that can be custom fitted to your mouth made by a dentist trained in sleep medicine.

And yes, dentists are increasingly being recruited to help study and treat sleep disorders. There are actually several ways in which we can help. Because we see our patients on a regular basis, we are uniquely qualified to diagnose early signs of SRBDs. For example, if you start to snore almost immediately after falling asleep in the dental chair, we will be able to discuss this important warning sign with you. We can also examine the back of your mouth to see if you possess any of the traits that point to SRBDs, including large tonsils and/or an elongated uvula — the tissue in the back of your throat that looks like a little punching bag.

So, if you want to stop snoring and start sleeping well or you think you may have a SRBD, call our office to schedule a basic oral exam and consultation. If you would like to learn more about the link between dentistry and the treatment of sleep disorders, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

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.”

Ensuring that your children have good oral health is (or should be) the goal of every parent or caregiver. But how confident are you about this topic? The following true/false quiz will help you evaluate your expertise while learning more about keeping your child's teeth healthy.

Questions

1. All children older than 6 months should receive a fluoride supplement every day.
2. Parents should start cleaning their child's teeth as soon as the first tooth appears.
3. Parents should start brushing their child's teeth with toothpaste that contains fluoride at age 3.
4. Children younger than 6 years should use enough toothpaste with fluoride to cover the toothbrush.
5. Parents should brush their child's teeth twice a day until the child can handle the toothbrush alone.
6. Young children should always use fluoride mouthrinses after brushing.

Answers

1. False. Check with your child's physician or dentist about your children's specific fluoride needs. If your drinking water does not have enough fluoride to help prevent cavities, parents of a child older than 6 months should discuss the need for a fluoride supplement with a physician or our office.
2. True. Start cleaning as soon as the first tooth appears by wiping the tooth every day with a clean, damp cloth. Once more teeth erupt, switch to a small, soft-bristled toothbrush.
3. False. Parents should start using toothpaste with fluoride to brush their children’s teeth at age 2. Only use toothpaste with fluoride earlier than age 2 if the child's doctor or our office recommends it.
4. False. Young children should use only a pea-sized amount of fluoride toothpaste. Fluoride is important for fighting cavities, but if children younger than 6 years swallow too much fluoride, their permanent teeth may develop white spots. Using no more than a pea-sized amount of toothpaste with fluoride can help prevent this from happening.
5. True. Because children usually do not have the skill to brush their teeth well until around age 4 or 5, parents should brush their young children's teeth thoroughly twice a day. You should continue doing this until the child can demonstrate a proper brushing technique.
6. False. Fluoride mouthrinses have a higher concentration of fluoride than toothpaste containing fluoride. Children younger than 6 years of age should not use fluoride mouthrinses unless your child's doctor or our office recommends it. Young children tend to swallow rather than spit it out, and swallowing too much fluoride before age 6 may cause the permanent teeth to have white spots.

Learn More

If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.”

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.”

A good night's sleep...have you been getting them lately? While everyone knows that sleep is important, did you know that we all spend about one-third of our lives asleep? And did you know that when deprived of sleep, the negative impact is detrimental on both an individual as well as at the societal level? These important facts are just some of the reasons why there has been an increased interest in studying sleep, sleep loss and sleep disorders.

If you have issues with sleep, you might have a sleep disorder — an epidemic problem that impacts approximately 50 to 70 million people in the US alone. Obstructive Sleep Apnea (“a” – without; “pnea” – breath) (OSA) is a medical condition that occurs when your tongue collapses against the back of your throat causing a significant reduction in your intake of air or even total temporary blockage. If left untreated, OSA can lead to an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease plus strokes and even impotence.

Please note that while your responses to the questions below do not equate to a diagnosis, sharing them with our office can be extremely beneficial in helping us properly evaluate and treat issues related to poor sleeping habits.

• Do you weigh 15 pounds or more than the normal weight range for your height, sex and age?
• If you are male, is your neck measurement 17 inches or more? Or if you are female, is it 16 inches or more?
• Do sleep partners routinely tell you that you are a loud snorer and/or that during your sleep you choke, gasp for air or briefly stop breathing?
• Do you often wake up still feeling tired after 8 or more hours of sleep?
• Do you often find yourself falling asleep at work or home during periods when you should be awake?
• Do you suffer from irritability, depression, loss of memory, poor judgment and/or concentration?

The first and most important step in treating sleep apnea is to obtain a proper diagnosis. Contact us today to schedule an appointment to discuss your questions about sleep apnea. We can assist in the diagnosis and treatment of sleeping disorder along with a physician trained in this area. And rest assured that we have many treatment options we can use to help you get a great night's sleep. To learn more about sleep apnea, continue reading the Dear Doctor magazine article “If You Snore, You Must Read More!”

Perhaps you've seen Nate Berkus on The Oprah Winfrey Show or watched his television program, The Nate Berkus Show. You may even have read his best-selling book, Home Rules: Transform the Place You Live Into a Place You'll Love. Regardless of where or how you discovered Berkus, you will surely have noticed his dazzling smile.

Berkus recently opened up about the facts behind his trademark smile during an interview with Dear Doctor magazine. First off, his smile is totally natural, as he never wore braces or had any cosmetic work, including porcelain veneers. However, Berkus does give credit to his childhood dentist for the preventative healthcare he received as a young boy. “I'm grateful for having been given fluoride treatments and sealants as a child,” he said. Nate also shared the important flossing advice he learned from his dentist that he still follows today: “Floss the ones you want to keep.” Berkus went on to say that he feels, “healthy habits should start at a young age.”

And we totally agree! For this reason we have put together the following list of facts and oral hygiene tips:

• Over 50% of plaque accumulation occurs in the protected areas between teeth — a place that may be difficult or even impossible to reach with a toothbrush.
• A thorough brushing may take up to two minutes at first, and it may feel awkward as you reach some places in your mouth.
• Remember, more is NOT always better! Brushing or flossing too hard can be damaging to your teeth and gums. And never saw back and forth with your floss.

To learn more about oral hygiene, including brushing and flossing techniques, you can continue reading the Dear Doctor article “Oral Hygiene Behavior - Dental Health For Life.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination, review your brushing and flossing techniques, and discuss any questions you have as well as treatment options. As needed, we will work with you to teach you the proper brushing and flossing techniques so that you feel confident before you leave our office. And to read the entire interview with Nate Berkus, please see the Dear Doctor article “Nate Berkus.”

When asked about her dazzling white smile, Cat Cora, the first female iron chef on the hit television series Iron Chef America, freely admits to maintaining the brightness of her smile with professional whitening sessions.

“With what I do, whitening your teeth is like getting your hair done, your nails done and everything else you have to do to be on television,” Cat recently told Dear Doctor magazine. However, she does have her limits. “I want my teeth to be white and healthy looking — but not stark white or looking like they could glow in the dark,” she said with a laugh.

Cat's perceptions and experiences with tooth whitening may accurately describe Hollywood, but through the power of media, celebrities and their respective fan bases, having attractive white teeth has become a goal for most people. This is because white teeth are subconsciously associated with youth and virility.

Here in the dental office, we can use professional-strength “power bleaching” to whiten teeth several shades in a single visit. To prevent irritation to the area surrounding the teeth being treated, we isolate the gums and skin of the mouth with a protective gel or a rubber barrier known as a dental dam. After the whitening solution is placed on the teeth, the process may be supplemented by heat or a light source to activate or enhance peroxide release.

For bleaching teeth at home, our office can make custom-fitted bleaching trays that you fill with a gel form of carbamide peroxide. Sometimes this whitening gel can cause a temporary tooth sensitivity to hot and cold, but this normally lasts for no more than four days after you stop bleaching your teeth.

To learn more about tooth whitening, you can continue reading the Dear Doctor magazine article “Teeth Whitening.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and discuss what treatment options will be best for you. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”

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

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

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

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

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

Athletic activity can boost your health, but many sports also carry some risk — especially to the teeth. This is something NFL wide receiver Jerry Rice well knows.

“Football can be brutal — injuries, including those to the face and mouth, are a common risk for any player,” Rice noted in an interview with Dear Doctor magazine. In fact, Rice himself chipped a couple of teeth, which were repaired with crowns. “There wasn't a lot of focus on protecting your teeth in high school,” Rice recalled.

You don't have to be a legend of the NFL to benefit from the type of high-quality mouthguard a dentist can make for you or your child. Consider that:

• An athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard.
• Mouthguards prevent an estimated 200,000 or more injuries each year.
• Sports-related dental injuries account for more than 600,000 emergency room visits annually.
• Each knocked-out tooth that is not properly preserved or replanted can cause lifetime dental costs of $10,000 to $20,000.

You and/or your child should wear a mouthguard if you participate in sports involving a ball, stick, puck, or physical contact with another player. Mouthguards should be used for practice as well as actual games.

It's also important to be aware that all mouthguards are not created equal. To get the highest level of protection and comfort, you'll want to have one custom-fitted and professionally made. This will involve a visit to our office so that we can make a precise model of your teeth that is used to create a custom guard. A properly fitted mouthguard is protective, comfortable, resilient, tear-resistant, odorless, tasteless and not bulky. It has excellent retention, fit, and sufficient thickness in critical areas.

If you are concerned about dental injuries or interested in learning more about mouthguards, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Jerry Rice, please see “Jerry Rice.” Dear Doctor also has more on “Athletic Mouthguards.” and “An Introduction to Sports Injuries & Dentistry.”

It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.

What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).

The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.

What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.

What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.

Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.

How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.

Contact us today to schedule an appointment to discuss your questions about sensitive teeth. You can also read the Dear Doctor magazine article “Sensitive Teeth.”

Design expert and television celebrity Nate Berkus has definite ideas about how to live. In a recent interview, he explained his ideas on design. He also talked about health, and how he keeps his teeth and mouth healthy.

From an initial design makeover that he did eight years ago on the Oprah Winfrey Show, Berkus has gone on to do 127 such makeovers. He was such a success that he now hosts his own daily talk show. He has also developed a line of home products for the Home Shopping Network and has his own design firm, Nate Berkus Associates. His clients include well-known restaurants and hotels as well as private homes. He has written articles for O Magazine and authored a book on the subject of transforming your home into a place you love.

“I realized many years ago that I wasn't going on Oprah to pick sofa colors and paint chips. I was there to lift people up through the way they live,” he says. His secret to design success is to “go with what you love.” He says, “Don't worry about mixing metals, eras or styles. If you love each item, you'll find a way to make it work.”

His common sense practical attitude continues when it comes to dental health. Berkus is blessed with a healthy mouth and teeth. He doesn't feel anxious when visiting the dentist because he usually has a good report. He has not needed orthodontics or cosmetic dentistry. He thanks his childhood dentist for giving him fluoride treatments and sealants, and for teaching him healthy dental hygiene habits.

Berkus brushes his teeth twice or even three times a day, with a manual or electric toothbrush — depending on whether he is at home or traveling. He also follows his dentist's advice about flossing: “Floss the ones you want to keep!” He says that he tried tooth whitening once, but he felt that the whiteness was “too white.” Now he simply works to maintain his natural tooth color and smile.

Contact us today to schedule an appointment to discuss your questions about maintaining healthy teeth. You can also learn more by reading the Dear Doctor magazine article “Nate Berkus, Helping Others Love the Way They Live.”

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.

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.

If you cringe at the appearance of your less than pearly whites when you look in the mirror, you are not alone. A frequently requested cosmetic procedure, teeth whitening is a very successful and relatively inexpensive way to enhance your smile. We can determine which whitening treatment will work best for you after performing a basic oral examination in our office. When will it work and when won't it? Here's some background:

Teeth most commonly become stained or discolored due to surface (extrinsic) changes, the most common of which are dietary and smoking. Foods including red wine, coffee, and tea can cause extrinsic staining. Teeth can also commonly become discolored or stained due to intrinsic (internal) reasons, such as changes in the structure of enamel or dentin or by incorporation of chromogenic (color generating) material into tooth tissue during formation or after eruption.

1. Toothpastes that claim to whiten teeth are only effective in removing plaque and other surface stains. Although most of these products contain mild abrasives that remove the plaque, they aren't capable of changing the underlying color of stained teeth.
2. Tooth polishing by your dentist or dental hygienist is effective in removing superficial staining, but will not change tooth color.
3. Teeth whitening systems work by bleaching, generally with the use of hydrogen peroxide. Using bleaching gels in custom made trays or whitening strips can be done at home, but is slow and the changes are gradual. We can perform quicker and more effective “power bleaching” in our dental office when precautions can be taken to ensure safety due to the higher concentrations of bleaching gels used. Teeth with intrinsic (internal) staining may need internal bleaching to whiten them and this can only be done in the dental office.
4. Teeth whitening results fade over time, but optimally last from six months to two years. Taking care of your newly whitened teeth by avoiding the foods, beverages, and habits that cause staining will help them remain whiter for longer.
5. If you have had previous cosmetic dentistry performed, including the placement of composite restorations, porcelain veneers, or crowns, teeth whitening may not be for you. Bleaching agents have little to no effect at all on the materials used to create these restorative products.

If you would like to discuss whitening your teeth with us, call today to make an appointment. To learn more about the various teeth whitening procedures, read the Dear Doctor magazine article “Teeth Whitening: Brighter, Lighter, Whiter…”

Some of the most popular smile enhancers on the market today are both over-the-counter (OTC) and professional teeth whitening products. And while studies indicate that bleaching can successfully achieve noticeable increases in whitening of stained teeth, there are some facts you need to know about these products and the results that they can deliver.

• Nearly all bleaching products contain the same basic ingredient, carbamide peroxide or its breakdown product, hydrogen peroxide. However, the products our office uses to professionally whiten your teeth are much stronger without compromising the health and safety of your teeth, gums, and mouth.
• OTC bleaches typically contain no more that 10% carbamide peroxide while professional bleaches can contain between 15% and 35%. And to make professional bleaching even more effective, we may use them in combination with specialized lights or lasers.
• Bleaching is NOT a permanent solution and thus results will diminish over time. The “fade rate” begins to occur 6 to 12 months after treatment.
• While you can't avoid the fading process, you can extend your bleaching results by avoiding foods and drinks that stain your teeth, such as red wine, red (tomato-based) sauces, coffee, tea, sodas/colas, and blueberries to name a few.
• Another method for extending your results is to use a straw when drinking beverages that can stain your teeth so that the liquid does not come in contact with your teeth.
• If you have visible crowns and/or veneers mixed with your natural front teeth, it may be quite difficult for you to bleach your natural teeth so that they perfectly match your veneers or crowns. Remember, tooth whitening is not effective on crowns, veneers, bridgework, or any type of artificial tooth.
• One of the most common side effects of whitening teeth is tooth sensitivity and irritation of the gum tissues. They both are usually temporary and often occur when you start bleaching; however, they generally subside after a few days.

Overall, bleaching your teeth is an effective way to brighten your smile with minimal side effects. If it is something you are interested in pursuing, talk it over with us first — even if you plan to use OTC products — so that you have a clear understanding about your specific options and projected outcomes. Or, learn more by reading the Dear Doctor article, “Teeth Whitening: Brighter, Lighter, Whiter....”

“Smile, and the world smiles with you,” the old saying goes. For people who are afraid to smile because they don't like how their smile looks, the twenty-first century offers a myriad of solutions. Smiling shows your teeth in their various shapes, colors, and sizes, your gums and gum line, your tooth alignment, spacing, and bite all in relation to the rest of your face. Any of these can now be improved.

Through the knowledge, skills, and combined experience of our dental team, it is now possible to make teeth whiter, brighter, and more evenly aligned, to alter tooth shape and size, and to make the teeth and gum line more proportionally balanced. Here are some options for cosmetic dentistry:

• Polish. Remove unwanted stains on outside tooth surfaces by having your teeth polished.
• Teeth Whitening. If teeth are stained or have just lost their luster, whitening is a safe and effective way to lighten a smile.
• Porcelain veneers. Applying a thin layer of dental porcelain restorative material to replace stained or damaged tooth enamel can truly change a smile.
• Porcelain crowns. If teeth are damaged by decay or trauma, porcelain crowns can replace the parts of the teeth that show above the gum line.
• Orthodontics. For teeth that are not in their correct and functional position, a variety of orthodontic techniques can be used including traditional braces, clear aligners and more—to improve crooked teeth or a malaligned bite.
• Dental implants. Nothing ruins a smile more than missing teeth. Entire teeth can be replaced, including the roots and the crowns, using dental implants. These are exact replicas of the natural teeth and can be made to match their neighbors exactly.

To learn more about all types of cosmetic dentistry, read “Cosmetic Dentistry, a Time for Change.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

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.

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

What is an impacted wisdom tooth?

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

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

When should wisdom teeth be removed?

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

What are the pros and cons?

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

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

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

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

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.

At Artistic and Family Dental Center, we strive to provide our patients with the most advanced dental treatment available. We offer a full range of services from crowns and bridges to overall smile makeovers – each designed to keep your smile looking beautiful and healthy for a lifetime. For more information about the services and treatments we provide, go to our website, www.artisticdental.com and click “Services Offered.” We are eager to assist you. Thank you for choosing Artistic and Family Dental Center for all your dental needs.

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

We hope you find our blog to be helpful, engaging and informational to ensure your best dental health.

As always, feel free to contact us with any dental questions or concerns.

Unfortunately, going to the dentist may still be a fear and anxiety provoking experience for some people even with modern dental techniques — an interesting phenomenon given the fact that no one is born with fear. It is either a learned response based on personal experience or one that is literally imagined based upon hearing of another's treatment. However, regardless of how it develops, a person's perception is their reality. The good news is that we are here to both listen and to offer our patients the benefits of oral sedation (sedation dentistry) that allows relaxation of mind and body. Thus you can focus on feeling peaceful rather than anxious.

While research has shown that 75% of all people surveyed have at least a little fear about going to the dentist, 10-15% have a great deal of fear. In fact, some of these people experience so much fear that they will cancel dental appointments or never schedule in the first place. If the latter describes your feelings, we encourage you to ask us about sedation or comfortable dentistry so that you can receive the oral healthcare you need and deserve to maintain optimal dental health.

And this good news gets even better when you understand that oral sedation does not even involve injections (shots)! We typically administer oral sedation in one of two methods: by giving you a pill to swallow whole or by giving you a tablet to place under your tongue (sub-lingually) where it dissolves. Once the prescription medication takes effect, you will remain awake and aware of your surroundings; however, the medication will help you transition from feeling nervous to a more comfortable state of being. Most of our patients describe their experience as “comfortable” or “relaxation” dentistry due to how they feel during their treatment. Simply put, the anti-anxiety (anxiolytic) medication almost literally dissolves away your fears.

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more by reading the article “Overcoming Dental Fear & Anxiety.”

Some of the most important lessons parents and caregivers can give their children involve teaching and demonstrating good oral health habits. The following tips from the Centers for Disease Control and Prevention (CDC) are some ideas for helping you keep your children's teeth healthy.

1. Start cleaning teeth early.
   As soon as a child's first tooth erupts (appears), you should clean it daily by using a clean, damp cloth. Once several teeth are in, you should switch to a small, soft-bristled toothbrush. As for using toothpaste containing fluoride, you typically should start using it to brush your child's teeth at around 2 years old. However, there are some situations in which we recommend using toothpaste earlier than age 2. It just depends on your child’s mouth and development.


2. Use the right amount of fluoride toothpaste.
   Many people are aware that using toothpaste containing fluoride is an important tool for fighting tooth decay. But, many are shocked to discover how much should be used and what could happen if too much is used and swallowed. Because children under the age of 6 may tend to swallow all or some portion of toothpaste, you should only use (and teach them to use) a small amount—about the size of a pea. Otherwise, they could be at risk for getting white spots on their permanent teeth years later from having swallowed too much fluoride. This is also a key reason for teaching children how to rinse and spit properly after brushing their teeth.


3. Supervise brushing.
   Because children's abilities and maturity can vary greatly from child to child, you should brush your children's teeth until they have demonstrated the ability to handle the task alone. However, even when you give them the power to self-brush, you need to monitor them closely to ensure they are doing a thorough job, using the correct amount of toothpaste, and not brushing in a way that could damage teeth or gums. Brushing for too long and too hard are bad habits that can be detrimental to teeth and gums.


4. Talk to your child's doctor and with our office.
   Did you know that your first appointment should be at age one? The age one dental visit can be critical in establishing great communication and trust, and preventing early childhood decay. And having a positive rapport with your dentist and physician is important at any age; however, it is vital for parents and caregivers to develop great communication with their healthcare professionals on behalf of their children from the start of life. Not only does it model good habits for them to observe, but it also helps you stay abreast of the oral and general health needs.

Want to learn more?

Contact us today to discuss your questions or to schedule a consultation. You can also learn more by reading the Dear Doctor article, “Oral Hygiene Behavior.”

Dentists often recommend bone grafting to ensure the success of dental implants. And it is likewise common for people to squirm a bit at the thought. Bone graft? That sounds serious. And maybe a bit, well, unappealing. These feelings are completely understandable. After all, this may be something you've never had to consider before. But there's no reason to worry. Here’s why:

1. Bone grafting is not new or experimental. It is actually a very routine part of the implant process, as well as other types of oral and periodontal surgery. And it is very successful when performed by an experienced doctor.
2. Bone grafting materials are processed for safety. The grafts used — whether synthetic or from a natural source, such as cow or human bone — have been specially treated for medical use.
3. Only a small amount of this bone-grafting material is needed. Once placed in the site of the missing tooth, it serves as a helpful scaffold your body uses to build more of its own bone in that spot.
4. Your implant will be more ideally positioned and may work better. It needs a good, strong foundation with which to fuse. But when teeth are lost, this supporting bone is often lost, too. This loss is often unpredictable and bone grafting limits the change that occurs. In fact that's one of the main benefits of replacing missing teeth with implants: they help prevent bone loss just as a natural tooth does.
5. Your implant will look so much better! Think about it: Your original tooth was supported to a certain height by the underlying bone. If that bone is now gone, the replacement tooth is going to be much longer because of the missing bone height. It may not look quite right without that additional support.

So if you want the best-looking and best-functioning implant possible, have no fear of bone grafting. And please contact us to discuss any of your concerns, or schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “Can Dentists Rebuild Bone?”

The medical term for dry mouth is xerostomia (“xero” – dry; “stomia” – mouth), something that many of us have experienced at some point in life. However, for some people it can be a chronic condition that is ideal for promoting tooth decay. It can also be a warning sign of a more serious health condition.

Dry mouth occurs when there is an insufficient flow of saliva, the fluid secreted by the salivary glands. Your major salivary glands are located in two places: inside the checks by the back top molars and in the floor of the mouth, with about six hundred tiny glands scattered throughout your mouth. And many people are surprised to learn that when they are functioning normally, saliva glands secret between two and four pints of saliva per day! While this may sound like a lot (and it is), saliva is key for buffering or neutralizing acids in the mouth. Without this powerful protection, tooth decay can increase quickly. This is especially true for older individuals who have exposed tooth root surfaces.

It is also important to note that there are times when mouth dryness is perfectly normal. For example, when you wake, you will probably have a slightly dry mouth because saliva flow slows at night. Another example is if you are dehydrated when it is simply a warning sign that you need to drink more fluids (especially water). Other causes for temporary dry mouth include stress as well as what you consume: coffee, alcohol, onions, and certain spices.

You can also have a dry mouth due to a side effect from an over-the-counter (OTC) or prescription medication. If it turns out that this is the cause in your case, you need to talk to the prescribing physician to see if there is something else you can take to avoid this side effect. If there are no substitutes, one tip you can try is to take several sips of water before taking the medication followed by a full glass of water, or chew gum containing xylitol, which moistens your mouth and decreases the risk of tooth decay.

Another cause of dry mouth is radiation treatment for cancer in the head and neck region. Yes, these treatments are crucial for fighting cancer; however, they can inflame, damage or destroy salivary glands. You can also have dry mouth from certain systemic (general body) or autoimmune (“auto” – self; “immune” – resistance system) diseases, diabetes, Parkinson's disease, cystic fibrosis and AIDS (Acquired Immune Deficiency Syndrome).

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

If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.

In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth's body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.

Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.

When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth's internal material. It is considered to be safe and reliable for this use.

The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.

At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.

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