Research has revealed that over 12 million Americans suffer from Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (tissues at the back of the mouth and throat) collapse causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. But, did you know that we can help treat your sleep apnea?

The primary method dentists who are trained in sleep medicine use to treat OSA is through the use of an oral appliance. Similar in look to an orthodontic retainer or sports mouthguard, oral appliances are designed to maintain an opened, unobstructed, upper airway during sleep. And while there are many different oral appliances available in the marketplace, less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. The key to success is to avoid those over-the-counter (OTC), generic mouthguards and instead use a professionally made and custom-fitted oral appliance, made from a precise models of your teeth and mouth. They are best at keeping your airway open and preventing the muscles and soft tissues from sagging down when relaxed during sleep. Other advantages of custom-fit oral appliances are that they can reposition your lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize your lower jaw and tongue; and increase the muscle tone of your tongue.

But Is Treatment Really That Important?

Absolutely! If undiagnosed and/or left untreated, sleep apnea can be life threatening. It can cause heart attacks, strokes, impotence, irregular heartbeat, high blood pressure, and heart disease — many of which can kill you.

Want To Learn More?

To learn more about sleep apnea, read the Dear Doctor article, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

A generation ago, hearing the term, “smile makeover,” would most likely have resulted in questions and puzzled looks. However, through the power of both the media and celebrities, today it has become a common household term with over 70% of all inquiries coming from people in the 31 to 50 year old age group, according to the American Academy of Cosmetic Dentistry (AACD). While some people seek cosmetic dentistry purely to boost their self-esteem, others pursue it to improve first impressions during business and social interactions, as many studies have revealed that first impressions are the ones that typically last the longest.

The AACD study also revealed other interesting statistics that support why a smile makeover is a wise choice that can yield a life-changing return on your investment — you!

• 99.7% of Americans believe a smile is an important social asset.
• 74% feel an unattractive smile can hurt chances for career success.
• 50% of all people polled were unsatisfied with their smile.

Another important study recently conducted by Beall Research & Training, Inc., an independent marketing research firm, used before and after photos of smile makeovers for polling purposes. The research found that people who have had a smile makeover are viewed by others as more attractive, intelligent, happy, successful in their career, friendly, interesting, kind, wealthy, and appealing to the opposite sex. This evidence clearly proves just how important a first impression can be as well as what it can silently communicate about you.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule a consultation. We look forward to meeting with you to learn about your specific concerns and to show you what we can do for you. You can also learn more by reading the Dear Doctor article, “The Impact Of A Smile Makeover.”

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

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

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

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

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

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

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

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

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 Drs. Milt Holloway and Jetta Holloway-Jankowski and their 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.

--The Dental Designs of Solomon Valley Team

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 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.

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

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

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

When it comes to patient comfort, one of the most important developments of the 21st century has been sedation dentistry, which enables you to relax in both mind and body allowing you to focus on feeling peaceful rather than anxious. And the prescription medications we use are some of the safest on the “therapeutic index” (the scale pharmacists and health professionals use to measure the safety of medications.) However, it is critical that we are aware of any medications you are already taking and your medical health and history, so let us know all about you so that we can avoid adverse (negative) reactions. Please note that we will take a full history to gain this information prior to any treatment or sedation — our utmost concern is your safety. During this time, it is vital that you are honest and feel comfortable sharing your responses to our questions. It's also our way of getting to know you and the first stage in relieving your anxiety. We will need to know all about:

• All medical conditions for which you are currently being treated.
• All prescription medications you are taking.
• Over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. This even includes aspirin, St. John's Wort, and Kava Kava. (Why? If taken daily for good heart health, aspirin thins your blood and thus may interfere with blood coagulation. And St. John's Wort and Kava Kava may be beneficial in helping relieve depression, but they can negatively impact how oral sedation medications work.)
• Foods and drinks you consume, such as alcohol and even grapefruit (juice or the fruit), can negatively impact how your body responds to both your treatment and sedation medications.
• And lastly, we need to know if you are a tobacco user — especially if you are a smoker. In addition to increasing your risks for oral and other cancers, tobacco can negatively influence the effectiveness of sedation medications.

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

For years, lasers have revolutionized the medical industry and now they are beginning to do the same within the field of dentistry. However, anytime new technologies are introduced, people naturally will have questions. Here is a list of frequently asked questions (FAQs).

What is a laser?

Lasers are beams of light that are a single wavelength and color. Laser is an acronym derived from “Light Amplification by Stimulated Emission of Radiation.”

How are they different from regular sunlight?

White light is made up of light with many wavelengths corresponding to the visible spectrum comprising the rainbow (red, orange, yellow, green, blue, indigo, and violet). Laser light consists of beams of a single color and hence a single wavelength of light, concentrated to a high energy level, which can penetrate living tissue.

How are they used in dentistry?

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. Examples of the most common hard tissue treatments include the diagnosis and removal of tooth decay, while the most common soft tissue treatments include the removal of gum tissue as it relates to cosmetic dentistry and the treatment of gum disease.

Are they safe?

Absolutely! Before blazing a trail in the field of dentistry, lasers have been used for years in the medical field with research evidence and the FDA approving both their safety and efficacy. In fact, they are minimally invasive and can result in less tissue removal, less bleeding and less discomfort for patients after surgery. And what could be better than that?

Want to learn more?

To learn more about lasers and how they are used in dentistry, read the article “Lasers Shine A Light On Dentistry.” And if you want to schedule an appointment, contact us today.

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

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

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

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.”

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

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

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

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

Having a whiter, brighter smile can do wonders for improving self-confidence, career opportunities, and interpersonal relationships, as demonstrated in numerous scientific studies. In fact, according to a poll conducted on behalf of the American Academy of Cosmetic Dentistry (AACD), the following was revealed:

• 99.7% of Americans believe a smile is an important social asset.
• 74% feel an unattractive smile can hurt chances for career success.
• 50% of all people polled were unsatisfied with their smile.

These statistics demonstrate why you should have a solid understanding about any cosmetic procedure — even teeth whitening — before making your decision to proceed. To help you ensure that you have the facts, we created the following list of questions.

• Am I a good candidate for tooth whitening?
• How much will the entire process cost?
• Does my insurance cover the cost (or any portion of the cost)?
• How does teeth whitening work?
• Is bleaching teeth safe?
• Will the bleaching agents damage tooth enamel?
• Can whitening treatments make my teeth sensitive?
• How does your professional bleaching differ from home whitening?
• What type of bleach and strength will you use?
• How long can I expect the results to last?
• What will the bleach do to my gums, filings, crowns, veneers, and/or bridgework?

Please note that we may cover most or all of these questions during your initial consultation; however, we encourage you to bring this list with you to ensure you get the answers you need so that you can make the best decision. To learn more now, continue reading the Dear Doctor article, “Teeth Whitening: Brighter, Lighter, Whiter....” Or, you can contact us to discuss your questions or to schedule an appointment.

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is an interesting condition because it can be hard to diagnose and often mimics many other conditions. It arises when there are problems inside the temporomandibular joint, and the muscles attached to it, causing pain. When treating TMD, we typically start by relieving the symptoms of pain and discomfort with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. We feel that it is critical to address your pain issues as soon as possible before preceding any further with treatment.

Once we have provided some pain relief and after having completed a thorough history and examination, we can move to the next phase of treatment. This may include the introduction of a bite guard or some form of oral appliance therapy. A bite guard is an unobtrusive yet rigid plastic horseshoe-shaped appliance that fits snuggly over the biting surfaces of the upper teeth. When in place and properly adjusted, this custom-made appliance allows your muscles and therefore jaw joints to relax. And it will prevent you from grinding your teeth, another contributing factor to TMD. We will probably ask you to wear it when sleeping or in times when you are feeling stressed when clenching or grinding habits may be active. We may also suggest that you obtain some relaxation therapy and/or biofeedback from a licensed therapist, as this can prove helpful in treating TMD.

If you have suffered from frequent jaw pain in the past and suspect that you may have TMD, please let us know so that we can address it at your next appointment. Or if you are currently 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 “TMD — Understanding The Great Imposter.”

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.”

For some people, going to the dentist is just like any other routine healthcare visit that they manage without any qualms. For others, the experience can cause some trepidation or even anxiety. In fact, some people even contemplate canceling appointments and neglecting their oral healthcare. If the latter better describes how you or someone you know feels about going to the dentist — even for a routine exam and cleaning — then we have great news for you! We offer our patients oral sedation (sedation dentistry) that allows you to relax both your mind and body so that you can focus on feeling peaceful and at ease rather than anxious.

What is oral sedation?

Often referred to as “comfortable” or “relaxation” dentistry, sedation dentistry offers an approach to dentistry that includes gentle management of your anxiety by using an anti-anxiety prescription medication that simply dissolves away your anxiety. The medications are administered by mouth (orally) to help transition you from feeling nervous to a more comfortable state of being.

Is it easy to take?

Another reason oral sedation is so popular is because it does not require an injection (shot), so, if you are afraid of needles, you simply do not need to worry. Typically, a pill is first placed under your tongue (sub-lingually) where it dissolves and penetrates the skin going straight into your system and then the rest is simply swallowed. This method and the quick-acting sedation medication make relaxation both effective and safe.

Is it safe?

Pharmacists and health professionals measure medications' effectiveness by measuring their “therapeutic index.” The larger the number is on this scale, the safer the drug. The oral sedation medications we use have the highest numbers possible on this scale and thus they are the least likely to cause any adverse (negative) reactions.

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 “Oral Sedation Dentistry.”

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

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

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

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

“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.

Anytime you are considering an implant surgery to replace missing teeth, you should take the time to gather the facts so that you have clear understanding of the procedure, your options and any potential risks. You should also feel comfortable with the dental team who is treating you. For these reasons, we created the following comprehensive list of questions so that you can obtain the answers you need to help you feel at ease prior to treatment.

• Am I a good candidate for dental implants?
• What is the success rate for dental implants?
• How long have you been placing implants and how many do you place each year?
• Can you show me some before and after photos that illustrate your work?
• What are the risks, benefits and alternatives to dental implants?
• Are dental implants ever rejected?
• How do you assess whether I have enough bone to anchor dental implants?
• Can you tell me about the surgical procedure for implant placement?
• How long will the entire process take from my first appointment until I have my implant(s) and crown(s) in place?
• Do I have to go without teeth while my implants are healing?
• What type of anesthesia will you use during my implant surgery?
• What can I expect in the hours and days following my implant surgery?
• How long will it take my implants to heal?
• How long can I expect my implants to last?
• Will there be any maintenance required with my implant(s)?
• How much will dental implant(s) cost?
• Will my insurance cover all or a portion of the cost?

To learn more, read “Dental Implants, Evaluating Your Professional Options For Care.” Or, you can contact us to discuss your questions or 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…”

It can start with a simple twinge or be as severe as excruciating pain. From time to time, we have patients asking questions about tooth sensitivity — what causes it? What can be done about it? For these reasons, we have put together the following list of frequently asked questions (FAQs) so that you can develop a healthy understanding about this painful and often avoidable condition.

What is tooth sensitivity?

The first layer of protection of the teeth is enamel. Enamel is a dense crystalline structure, the hardest substance produced by animals. It is an inert substance that has no nerve supply and thus it protects the teeth from temperature and pressure changes. When it is compromised, worn thin, or exposed due to gum recession, it leaves the dentin exposed and vulnerable. Unlike enamel, dentin is living and has delicate nerve fibers within it.

What triggers tooth sensitivity?

Once dentin is exposed, it can become sensitive. It typically occurs when the dentin comes in contact with heat, cold, or the “double whammy” combination of both cold and sweets. Even the bristles of a soft toothbrush can irritate exposed dentin causing sensitivity and pain.

What can be done to minimize tooth sensitivity?

One of the simplest ways to minimize or prevent sensitivity is by teaching proper brushing techniques so that teeth are cleaned without causing either sensitivity or damage. Brushing too hard is a frequent culprit. Being overzealous can literally cause gum recession, leave dentin, and wear it away leaving it grooved. Another step to minimize sensitivity is to use a toothpaste containing fluoride. Fluoride increases the strength of tooth surfaces and thus makes teeth more resistant to attack by acids and sweets. If severe, we may need to apply a barrier to cover the sensitive areas. These barriers may range from concentrated fluoride varnishes to replacing lost tooth structure with filling materials.

Want to learn more?

To learn more about this topic, read the article “Sensitive Teeth.” Or if you are suffering from this condition, please contact our office to schedule an appointment. During your appointment, we will conduct a thorough examination to ascertain what is causing your sensitivity as well as what we can do to treat and/or prevent future issues.

When you begin a smile makeover in our office, you are embarking on an exciting partnership with my laboratory technician and me. You should be full of excitement and anticipation — if you have been dissatisfied with your current smile, and you have great expectations for the results of this project. You will really like what you see in your mirror.

Being completely satisfied with your new look depends upon successful communication — between you and me and also between my dental lab technician and me. As you might expect, your perceptions of how your teeth appear are different from a dentist's perceptions. My education leads me to think of factors that untrained individuals probably won't consider, such as crown (tooth) length, midlines (how the teeth line up with other facial features) and the distance from gum to lip.

It is helpful to be able to describe what you like and don't like about your current smile, and what changes you would like to see. Using visual aids is a good idea. Bring photos and magazine illustrations to show what you have in mind. (Remember that we cannot make you look exactly like a celebrity or anyone else. The pictures are guidelines.)

Things to think about:

• The color, size, shape, alignment and spacing of your teeth.
• How much of your teeth and gum tissues show when your lips are relaxed and when you smile.
• Tooth color: bright “Hollywood” white or more natural looking off-white.

Your makeover is more likely to meet your expectations if you get an advanced view of the results. Computer imaging is one way to do this. Another is for us to make a mock-up of the proposed dental work in tooth-colored wax on models of your mouth.

Finally, a “Provisional Restoration” can be used as a test to make sure that what I envision is also what you, the patient, want to see. A provisional restoration, made from temporary materials, gives you a chance to test out the changes and make sure they work for you — that they not only look good, but they are also functional in terms of biting, chewing, speech, and gum health.

If the provisional restoration works, it is used as a blueprint to make durable and long lasting porcelains in the same design. We will take impressions of the provisional restoration and communicate the relevant information to a dental laboratory technician, who will make the final porcelain tooth replicas for your new smile.

Competent communication and a provisional restoration will put you on track to meet your expectations and obtain the most aesthetic and functional result in your Smile Makeover.

Contact us today to schedule an appointment to discuss your questions about Smile Makeovers. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

If you've ever looked through a magazine and viewed the perfectly aligned white smiles of celebrities and models, you may be already familiar with the look of porcelain veneers. To achieve a picture-perfect smile, many Hollywood stars choose porcelain veneers (thin-layers of porcelain) that are bonded to the front of teeth allowing for the alteration of tooth position, shape, size and color. By fixing imperfections, as well as whitening them, veneers offer celebrities a perfect smile that, when maintained properly, can last for several decades.

Evaluation: If porcelain veneers sound appealing, our office can help you decide if you're a good candidate for them. We will ensure you have sufficient tooth structure, that your teeth are in more or less a normal position, and that symmetrical gum contours are present, allowing for proper “framing” of the teeth, necessary for a beautiful smile.

The Process: Once it's been determined that you're a good candidate for veneers, our office will begin a smile analysis using computer imaging to digitally replicate your smile and then fabricate a mock-up smile made of tooth-colored wax. We will work with you to determine the right color and shade for your veneers. You can choose the brightest, whitest “Hollywood smile” or opt for a more natural color and enhanced look.

Next Steps: After your initial appointment, it typically takes the laboratory one week to fabricate your porcelain veneers. The insertion of your veneers can be done with or without a local anesthetic. We will place the veneers on your teeth with a light-sensitive resin, which sets with the use of a white light, effectively bonding them to your teeth. While you may initially experience some tooth sensitivity to hot or cold, this will disappear after a few days. Maintaining your perfect smile requires simple brushing and flossing techniques and routine check ups.

Contact us today to schedule an appointment to discuss any questions you may have regarding porcelain veneers. Read more about this topic in the Dear Doctor magazine article “Smile Design, Enhanced by Porcelain Veneers.”

If you don't like your smile when you look in the mirror, or feel self-conscious because your teeth are discolored, there are a variety of whitening procedures that can help you obtain the smile of your dreams.

Choosing the Right White: With strips, trays and toothpastes all claiming to be the best tooth whitening systems, it can be hard to choose how to whiten your teeth. Our office can help you decide the best approach based on your individual needs, time constraints and budget. Whiteners may not correct all types of discolorations.

Whitening in Our Office: This procedure is called chair-side or professional bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour. We use an in-office whitening gel that is professionally applied to your teeth and activated by a light source, giving you significantly whiter teeth in less than an hour. Typically, teeth with a yellowish hue respond best to whitening.

Whitening Your Teeth at Home: If you are an adult who practices good oral hygiene and doesn't suffer from periodontal disease, our office can help you decide whether an at-home whitening system, or having your teeth whitened in our office best meets your needs. If you decide to go with an at-home system, you will wear a custom-made whitening tray that looks like a thin, transparent night guard. You fill the tray with a mild whitening gel and need to wear the gel filled tray for a specified period of time each day (per our office's instructions). This procedure must be continued over a period of time that generally extends from 2-4 weeks.

Whitening Products Found in Stores: If you are considering over-the-counter whitening products we can also recommend products that will offer you the best results. Whitening toothpastes that have the American Dental Association (ADA) Seal of Acceptance contain special chemical or polishing agents that generally provide some stain removal effect.

Contact us today to schedule an appointment or to discuss any questions that you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening.”

If you fear a visit to the dentist, you are not alone. Studies have shown that up to 75% of people surveyed have some fear of dental visits, and 10 to 15% fear the dentist so much that they avoid any dental treatment. This can have serious repercussions, leading to toothaches, infections, and loss of teeth. Poor oral health can even negatively affect your general state of health.

Here's the good news. Even people who are the most afraid of the dentist can learn to reduce their fear and feel calm and safe during a dental visit.

Dental fears develop when people have bad dental experiences. For many, the problem is a sense of loss of control. Sometimes, fears are based on stories people have heard or even movies they have seen.

The feeling of being afraid reinforces your fear. If you experience the rapid heartbeat, sweaty palms, tensed muscles, and other symptoms of fear while in the dentist chair, you are likely to remember these unpleasant feelings afterward and become even more fearful. In order to reverse this process, you need to begin to associate dental visits with good experiences and a sense of control. Here's how we can help you do this:

• Know that you are not alone and we are here to help you.
• Talk to us about your fears. We are sure to listen and not be judgmental. If you don't talk about it, you can't get over it.
• We will start by doing things that cause only mild or no anxiety. We want each visit to be a good experience, so you are able to leave our office with a feeling that it was okay, and you can do it again.
• Our goal is for you to overcome your fear. We will make this a priority and that priority is as important as “fixing your teeth.” We will be happy to talk about the time and fees associated with your treatment so that you can overcome your fear and gain a sense of control of the situation.
• It took a while for your fears to develop, so you should realize that it will also take a while to get over them. We will spend as much time as you need to get over your fears and will not rush you into doing anything for which you are not ready.

Contact us today to schedule an appointment to discuss your questions about any fears you may have. You can also learn more by reading the Dear Doctor magazine article “Overcoming Dental Fear & Anxiety.”

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

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

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

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

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

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

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

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

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

Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.

If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.

Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.

What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.

At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.

Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.

Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”

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

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

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

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

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

Dental implants are a fascinating treatment option that can be life changing when used properly. They have also experienced tremendous scientific advancements and press over the years making them highly desirable by people of all walks of life. See how much you really know about dental implants by taking our quick and easy true/false self test.

1. Dental implants can produce lifelike results that are indistinguishable from natural surrounding teeth.
   True or False
2. Many dental professionals consider dental implants as a “third set of teeth,” as they can last a lifetime when properly maintained.
   True or False
3. A dental implant is a safe option that is suitable for all patients regardless of age.
   True or False
4. When properly placed and maintained, dental implants have a 90% success rate.
   True or False
5. If you do not have enough bone to support a successful dental implant, there is not much that can be done.
   True or False
6. When teeth are missing, the face tends to have a sunken-in appearance called, “posterior bite collapse.”
   True or False
7. One of the positives of dental implants is that they do not affect adjacent teeth.
   True or False
8. Dental implants typically cost significantly more than other options, such as a bridge, over the course of a lifetime.
   True or False
9. Dental implants are always more desirable than bridgework or other treatment options for missing teeth.
   True or False
10. Dental implants can lead to improved health due to better nutrition and proper digestion.
    True or False

1. True. Dental implants can appear as beautiful, natural teeth.
2. True. When properly maintained, implants provide the same function as natural teeth roots.
3. False. Dental implants are not suitable for replacing primary teeth or permanent teeth in young children or teenagers. They are best used when facial and jaw development is complete.
4. False. They have a 95% success rate.
5. False. If you do not have enough bone for a dental implant, you may be a candidate for a bone graft — a process in which we “grow” the bone we need for the implant.
6. True. This condition is often totally reversible once teeth have been restored through implants or bridgework.
7. True. Unlike bridgework, dental implants do not affect surrounding teeth.
8. False. They are less expensive in the long run.
9. False. Sometimes a bridge is better than an implant.
10. True. Once teeth are restored, chewing and digesting food is easier; thus health improves.

To learn more, continue reading the Dear Doctor magazine article “Dental Implants, Your Third Set of Teeth.” Or, you can contact us today to schedule an appointment or to discuss your questions.

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.

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.

Yes, dental x-rays are a safe and vital tool we use for measuring and monitoring your oral health. We feel it is imperative to ensure that our patients have the facts — especially when it comes to their oral healthcare. This is why we want to respond to this important question about the safety of dental x-rays.

We want you to know what they are, how they are used, what makes them a safe and effective tool, and why they are so important to dentistry and your health. X-rays are a form of electromagnetic radiation, in fact, just like natural daylight, except they have a much shorter wavelength. And because they are a form of ionizing radiation, they can easily penetrate bodily tissues without causing any harm when used properly. The reasons we use them are obvious; they help us literally see what is unseen. For example, they enable us to see bone structure and roots of teeth among other things, and are commonly used for diagnosing tooth decay. Furthermore, today's x-ray machines and other image capturing techniques are so sophisticated and sensitive that the amount of radiation required for diagnosis is almost nothing when compared to what you get from the background radiation present in everyday living. In fact, the average single digital periapical (“peri” – around; “apical” – root end of a tooth) film is equal to 1/10 the amount of everyday natural environmental exposure. These facts make it clear that dental x-rays are completely safe and, thus, are nothing you need to be concerned about.

Learn more about this topic by reading the Dear Doctor magazine article “X-ray Frequency And Safety.” If you need to schedule an appointment, contact us today.

What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.

What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.

Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.

Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.

What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.

What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.

Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.

Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.

Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”

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

Self Test For Sleep Apnea

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

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

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

Learn More

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

How much do you know about dental implants? Test yourself with this quiz.

1. Earliest recorded attempts at using dental implants were from
1. Medieval England
2. The ancient Mayans
3. U.S.A. in the 1950s
2. Dental implants are called endosseous. What does this mean?
1. They fuse with the bone
2. They are inside the mouth
3. They are not real teeth
3. What are most dental implants made of?
1. Aluminum
2. Titanium
3. Steel
4. What part of the tooth does an implant replace?
1. The implant is the root replacement
2. The implant is the root plus the crown
3. The implant is the crown
5. What is the success rate of dental implants?
1. 50 percent or less
2. 75 percent
3. 95 percent or more
6. What could cause an implant to fail?
1. Smoking or drug use
2. Poor bone quality and quantity at the implant site
3. Both of the above
7. What is a tooth's emergence profile?
1. The implant and crown's shape as it emerges from beneath the gum line
2. A measure of the urgency of the tooth replacement
3. A measure of the time it takes for you to be able to chew on the new implant
8. What are some of the factors that go into the aesthetics of designing the crown?
1. Choice of materials
2. Color matching
3. Both of the above

1. b. The concept of dental implants goes back to the Mayan civilization in 600 AD.
2. a. The word endosseous (from endo meaning within and osseo meaning bone) refers to the implant's ability to fuse with or integrate with the bone in which it is placed.
3. b. Most implants are made of a titanium alloy, a metallic substance that is not rejected by the body and is able to fuse with the bone.
4. a. The term “implant” refers to the root replacement, which is anchored in the gum and bone. A crown is put around the implant where it emerges from the gumline.
5. c. The majority of studies have shown long term success rates of over 95 percent.
6. c. Factors that could cause an implant to fail include general health concerns such as smoking and drug use, osteoporosis, or a compromised immune system; poor bone quality or quantity; and poor maintenance such as lack of proper brushing and flossing.
7. a. The emergence profile has a lot to do with the implant's natural appearance. It involves the way the crown, which attaches to the implant, seemingly emerges through the gum tissue like a natural tooth.
8. c. Choices such as materials, color, and position can be worked out in the design of a customized temporary crown, which acts as a template or blueprint for a final crown.

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

We are often asked about the role the tongue plays with bad breath or halitosis, as it is known medically. The truth is that everyone will experience it at some point in life; however, there can be a number of reasons for its cause. Some of these include:

• Consuming odorous foods and/or drinks such as coffee, onions and garlic. This is usually just a temporary condition that can be resolved by brushing and flossing your teeth and using mouthwash. Also consider chewing gum containing xylitol, a sugar-free gum that both promotes saliva flow and reduces tooth decay.
• Diabetes, a disease caused by a faulty metabolism of sugar, as well as diseases of the liver and kidneys can also cause bad breath. Be sure to always let all your health care professionals know if you have any unusual symptoms or you been diagnosed with any of these or other illnesses.
• Poor oral hygiene, which causes gingivitis (gum disease), is one of the most common reasons for bad breath. And if your gum disease is progressive, you could eventually lose your teeth.
• If you use tobacco and regularly drink large amounts of alcohol, you are dramatically increasing the likelihood of having halitosis.
• And lastly, if you do not drink enough water to maintain proper hydration, you can develop bad breath.

There are more than 600 types of bacteria found in the average mouth, many of which can cause bad breath. And the back of the tongue is where these bacteria typically produce Volatile Sulfur Compounds (VSC), the culprits responsible for the worst odors attributed to halitosis.

As for cleaning your tongue, there are two common methods. You can use your toothbrush to brush your tongue, or you can use a tongue-scraper. The latter can generally be purchased at a drug or discount store. The keys to remember are that a clean, healthy tongue should be pink in color and not have a yellow or brownish coating.

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?”

We pride ourselves on using the latest, scientifically proven technologies so that we can obtain and maintain optimal oral health for our patients. The word “laser” is an acronym for “Light Amplification by Stimulated Emission of Radiation” and, within the world of dentistry, lasers are used for a variety of procedures and therapies. Simply put, this means that light from a particular crystalline source is stimulated electronically and by the use of mirrors to high energy levels, which can penetrate living tissue. Specific lasers with different light emitting capabilities can be used in dentistry — some on hard tissues and others for soft tissues like gum and oral mucous (skin) membranes within the mouth. Uses include diagnosing cavities, others for removing diseased gum tissues, for example. But best of all, lasers are minimally invasive and can result in less tissue removal, less bleeding, and less discomfort for patients after surgery. For example, using a laser, allows preparation of smaller cavities for fillings by vaporizing away tooth decay often without any anesthesia (numbing of the teeth) or a drill.

If you want to learn more about lasers and how they are used in dentistry, read the article “Lasers Shine A Light On Dentistry.” And if you want to schedule an appointment, contact us today.

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.

Millions of people suffer from mouth dryness, but most people just never talk about it. As your dental care providers, we don't want you to keep it a secret anymore and mouth dryness really can be a problem.

Why? Saliva is a very important fluid that moisturizes, lubricates, and aids in the first stages of chewing and digestion. A normal flow of saliva provides antibacterial benefits that even protect against cavities by buffering the effects of acids. It can also make the surfaces of your teeth more vulnerable to abrasion and erosion. Without enough saliva, you may be especially at risk for not only tooth decay, but even yeast infections.

Causes of dryness include dehydration and even morning breath, both of which are normal. Smoking, alcohol and coffee drinking also cause dryness. It is also a side effect of many medications. Although mouth dryness is not a disease in itself, it could be a symptom of salivary gland or other systemic (general body) disease.

As a first step in the treatment, we will assess your situation by taking a detailed habit, diet, medical, and drug history to properly assess the cause and establish whether this is a local condition affecting only your mouth or an indication of a generalized bodily problem.

It's always helpful to keep yourself well hydrated by simply drinking a sufficient amount of water every day and by using good daily oral hygiene to remove dental bacterial plaque. Chewing gum, especially containing Xylitol, will also help promote saliva flow and keep your mouth moist. Be careful not to suck on candy or mints, because they are likely to cause decay. There are also prescription medications that can be used to promote more saliva flow.

Contact us today to schedule an appointment or to discuss your dry mouth and what we can do to help. For more information read the article on Dry Mouth in Dear Doctor magazine.

Even with good dental hygiene and care, your teeth may show signs of wear as you age. Fortunately, we now have ways to treat these symptoms of aging and restore a youthful look and function to your teeth and jaws.

How Do Teeth Wear?

All the tissues in your body are constantly in a process of breaking down (catabolism) and rebuilding (anabolism). During childhood the anabolic processes exceed the catabolic processes. But after you have reached physical maturity the balance changes and the breakdown process begins to draw ahead of the building up. The result: signs of wear.

In your teeth, the outer layer, the enamel, is a hard, mineralized substance that is resistant to wear. Under the enamel is a layer called dentin, which is a living tissue something like bone. As teeth age, the dentin layer thickens, causing teeth to lose some of their whiteness. Most wear to your teeth comes from the pressure of the upper and lower teeth's biting surfaces against each other. How much wear occurs depends on your bite or occlusion (how the teeth are aligned, and how they meet) and the ways in which you use your teeth.

Constant interactions between the biting surfaces of your teeth result in removal of small amounts of enamel. Your body naturally compensates for this wearing away of material. As teeth wear, they erupt from your jaws by tiny amounts, moving slightly up or down to stay in the proper occlusal relation with the teeth on the other jaw. They also slowly move toward the front of your mouth.

If the wear becomes excessive, your body can no longer compensate for it. At this point you may find that your bite relationships are not working correctly, and the lower third of your face loses height. This creates or accentuates an older appearance.

Some people clench or grind their teeth, applying greater than normal — and damaging — forces to their teeth. This problem, often a reaction to stress, is called bruxism. It can cause a number of problems from jaw pain to loose teeth or excessive wear or tooth fractures. If you suffer from excessive wear due to bruxism, a professionally made mouthguard may prevent further damage.

Modern Dentistry Can Restore a Youthful Look

Modern dentistry can successfully restore the normal shape, appearance and function of worn teeth by installing porcelain crowns or veneers. These not only replace the tooth structure lost through wear, but they also restore the bite relationship. Crowns on excessively worn teeth can dramatically improve tooth color and facial appearance, resulting in a more harmonious, younger look.

Contact us today to schedule an appointment to discuss your questions about dental wear and aging. You can also learn more by reading the Dear Doctor magazine article “How and Why Teeth Wear.”

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.”

As the co-host of one of America's most beloved television game shows, Wheel of Fortune, Vanna White is recognized for her beautiful gowns and her dazzling smile. However, during an exclusive interview with Dear Doctor magazine, she shared her experiences with cosmetic dentistry. “I had a bridge put in probably 30 years ago where I had a tooth pulled and there was a space,” Vanna said.

Prior to having a permanent tooth pulled, most people are concerned with what can be done to replace it. It's important to follow through and do exactly that. This is especially true with back teeth. Just because you can't see them, it doesn't mean you won't face problems if they are not replaced.

For example, did you know that missing posterior (back) teeth can lead to a wide array or problems with the remaining teeth, muscles, ligaments, joints and jaw bones? This includes:

• A decrease in chewing efficiency that in turn can impact your diet, nutrition and overall health
• Excessive erosion or wear of remaining teeth
• Tipping, migration, rotation and even loss of adjacent remaining teeth
• Painful jaw problems such as Temporomandibular Dysfunction (TMD)

One treatment option is to follow in Vanna's footsteps and consider a fixed bridge. This is an excellent option when dental implants won't work. And through our artistry, we can easily blend them in color and appearance with your surrounding teeth.

When implants are possible, they represent the best option. They are easily maintained and are a durable, long-lasting solution that can increase bite support.

To learn more about this topic, continue reading the Dear Doctor magazine article “Replacing Back Teeth.” Or if you are already missing a permanent tooth, you can contact us today to schedule an appointment so that we can conduct a thorough examination. We will also address any questions you have as well as your treatment options. And if you want to read the entire feature article on Vanna White, continue reading “Vanna White.”

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.”

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

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.”

If you like soft drinks and carbonated colas, beware. Acids in these drinks may be dissolving the minerals in your teeth — a process called chemical erosion. And don't think that natural fruit juices or sports and high energy drinks are any better than sodas. They also contain acids that dissolve the surface enamel of your teeth. Once your enamel is lost, it is gone forever. It cannot naturally recover.

Sadly, teeth in children and teenagers — an age group most likely to drink large quantities of soda and juices — may be more easily eroded by acids. These youngsters have not had long-term exposure to fluorides which harden tooth enamel and protects them from acid erosion.

The Difference between Erosion and Decay
Chemical erosion is not the same as tooth decay (cavities). In chemical erosion, acids in your mouth react directly with minerals in the outer enamel of your teeth. In the case of tooth decay, bacteria in dental plaque (a bacterial film that forms on your teeth) utilize the sugars in the drinks and produce acids that attack your teeth.

After Acidic Exposure, Wait 30 Minutes to an Hour before Brushing
You may think that the solution to chemical erosion is to brush the acidic solution from your teeth as soon after drinking them as possible. But tooth brushing immediately after can actually accelerate chemical erosion and make it worse. After they are bathed in an acidic solution, minerals in the tooth surface become partially dissolved. Brushing at this time may brush away the affected layer. If you wait a half hour to an hour, your saliva will have time to neutralize the acids and harden the tooth surface by adding minerals back into it.

Drinks Less Likely to Cause Dental Erosion
Instead of drinking colas and sports drinks, stick to water and/or milk, which have the added benefit of supplying calcium to help add minerals back to the tooth surface.

If you must sip on juices or soft drinks, try to do so only at mealtimes. This is preferable to drinking them all day long, which leaves your teeth constantly bathed in an acid solution. Avoid swishing the drinks in your mouth, and sip them with a straw to reduce contact between acidic drinks and your teeth.

Contact us today to schedule an appointment to discuss your questions about acid erosion of teeth. You can also learn more by reading the Dear Doctor magazine article “Dental Erosion.”

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.”

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!

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.”