My Blog
By Roula Giannos, DMD
March 23, 2020
Category: Oral Health
Tags: gum disease  
ConsiderSavingaToothBeforeyouDecidetoReplaceit

Dental implants are the ideal tooth replacement with their life-like appearance, high success rate and durability. If you have significant dental issues, they may seem like the perfect answer. But before you choose to replace a problem tooth with an implant, it might be to your benefit — financially and health-wise — to consider saving the tooth first.

Tooth decay can be a formidable enemy, destroying both tooth structure and the tooth’s connectivity to the jaw. But there are treatment options even for heavily decayed teeth, including cavity filling with composite resins or porcelain that look and function like natural teeth. For decay deep within a tooth’s interior, root canal therapy can rid the pulp chamber and root canals of decay and seal them from future occurrences. The treatment’s success rate is comparable to and less expensive than implants.

While decay damage can be significant, adult teeth are more at risk from periodontal (gum) disease, a gum infection caused by bacterial plaque on tooth surfaces. This disease can weaken gum tissues until they eventually detach from the teeth and lead to loss. Gum disease, though, can often be brought under control by techniques called scaling and root planing that deep clean tooth and root surfaces of plaque and calculus (hardened plaque deposits).

Scaling may require multiple sessions and will require a greater effort from the patient in performing daily oral hygiene and visiting the dentist regularly to closely monitor gum health. And more advanced cases may require surgery to access deep pockets of infection or repair damaged tissues. But even with this effort, treating gum disease rather than replacing a tooth could be much less costly — and you’ll be able to preserve your own teeth.

On the other hand, the disease process may have gone on too long and caused too much damage for the tooth to be saved. In these cases, the best option is to remove it and install a restoration like an implant. By first completing a complete dental examination, we’ll be better able to advise you whether your best course is a “tooth rescue” or a replacement.

If you would like more information on dental repair or replacement options, please contact us or schedule an appointment for a consultation.

HughJackmanIsAllSmilesforHisNewBroadway-InspiredShow

To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.

With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.

The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…

Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.

A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.

And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.

One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.

If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”

By Roula Giannos, DMD
March 03, 2020
Category: Dental Procedures
GumDiseaseisStillaThreattoYourDentalImplants

You’ve invested quite a bit in your new dental implants. And it truly is an investment: because of implants’ potential longevity, their long-term costs could actually be lower than other restorations whose upfront costs might be less.

But to better ensure their longevity, you’ll need to keep your implants and the natural tissues supporting them clean of bacterial plaque, a sticky biofilm that can cause periodontal (gum) disease. Although the implant itself is unaffected by disease, the natural tissues around it can be.  An infection could ultimately weaken the bone supporting the implant and lead to its failure.

Such an infection involving implants could advance rapidly because they don’t have the natural defenses of the original teeth. Our natural teeth are connected to the jaw through the periodontal ligament, a collagen network that attaches to both the teeth and the bone through tiny tissue fibers. This connection also provides access to antibodies produced by the body to fight infection.

By contrast, we place implants directly into the jawbone. While this creates a very secure attachment, the implant won’t have the same connection as teeth with the body’s immune system. That means any infection that develops in surrounding tissues can spread much more rapidly—and so must be dealt with promptly.

Treating this particular form of gum disease (known as peri-implantitis) is similar to infections with natural teeth and gums, with one important difference involving the tools we use to remove plaque from them. While natural teeth can handle metal scalers and curettes, these can create microscopic scratches in the porcelain and metal surfaces of an implant and create havens for further bacterial growth. Instead, we use instruments made of plastic or resin that won’t scratch, as well as ultrasonic equipment to vibrate plaque loose.

To avoid an infection, it’s important that you brush your implants and surrounding tissues just like you would your natural teeth (be sure you use a soft-bristled brush). And keep up regular dental visits for thorough cleanings and checkups to stay ahead of any developing gum infection. Maintaining your dentures will help ensure they continue to brighten your smile for a long time.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance: Implant Teeth Must be Cleaned Differently.”

By Roula Giannos, DMD
February 22, 2020
Category: Oral Health
Tags: loose tooth  
ALooseToothisaSignofDeeperDentalTrouble

A loose primary (“baby”) tooth is often a cause for celebration. A loose permanent tooth, however, is a cause for concern. A permanent tooth shouldn't even wiggle.

If you have a loose tooth, it's likely you have a deeper dental problem. Here are the top underlying causes for loose teeth.

Gum disease. Teeth are held in place by an elastic tissue called the periodontal ligament. But advanced periodontal (gum) disease, a bacterial infection usually caused by film buildup on teeth called dental plaque, can damage the ligament and cause it to detach. If it's not treated, it could lead to tooth loss.

Bite-related trauma. A normal bite helps balance out the forces generated when we chew so they don't damage the teeth. But if a misaligned tooth protrudes higher from the jaw, the opposing tooth will likely create more downward pressure on it while chewing. This can stress the tooth's supporting ligament to the point of looseness.

Self-inflicted trauma. While they may be trendy, tongue jewelry can cause dental damage. A wearer who clicks the “barbell” of a tongue stud against their teeth could be creating conditions conducive for gum damage and bone loss, which can cause tooth looseness. Similarly, taking orthodontics into your own hands could also damage your teeth, especially if you have undiagnosed gum disease.

Genetics. Although you can't prevent it, the type of resistance or susceptibility you inherited from your parents (as well as your dental anatomy) can cause you dental problems. Thinner gum tissues, especially around the roots, can make you more susceptible to gum disease or dental trauma, which in turn could contribute to tooth looseness.

There are things you can do to lessen your chance of loose teeth. Brush and floss every day to remove disease-causing bacterial plaque and see a dentist regularly for cleanings to reduce your risk of gum disease. If you have any misaligned teeth, consult with an orthodontist about possible treatment. And avoid oral jewelry and DIY orthodontics.

If you do notice a loose tooth, see us as soon as possible. We'll need to diagnose the underlying cause and create a treatment plan for it. We may also need to splint the tooth to its neighbors to stabilize it and reduce your risk of losing it permanently.

If you would like more information on tooth mobility, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Permanent Teeth Become Loose.”

GiveYourChildAddedProtectionAgainstCavitiesWithTopicalFluoride

Keeping your child’s teeth and gums healthy may sometimes seem like “one step forward, two steps back.” You do all the right things like daily brushing and flossing, and keeping sugar consumption to a minimum. But they’re still getting too many cavities.

We can add something else to what you’re already doing to decrease their cavity rate: apply a concentrated fluoride mixture (stronger than what’s found in toothpaste or drinking water) directly to their teeth. Studies have shown that topical fluoride is effective at reducing the risk of new cavities in children at high risk for decay, and may even reverse early decay.

Topical fluoride can be applied as a gel, foam or varnish. The particular method used depends on factors like the child’s age or the preference of the dentist. But any of the three methods can deliver a short-term, high dose of fluoride to the teeth.

As a result, the burst of fluoride strengthens tooth enamel against decay, with plenty of evidence of its effectiveness. As such, the American Dental Association recommends periodic topical fluoride applications for children older than 6, and especially those that appear to be at higher risk for decay.

You might, however, be concerned about the long-term health effects of these stronger concentrations of fluoride. Again, research indicates that the only long-term hazard associated with too much fluoride is a condition called fluorosis, which produces heavy tooth staining. Fluorosis, though, is more of an appearance issue and doesn’t harm the tooth itself. And it can be avoided in the case of topical fluoride by performing the procedure correctly and conservatively.

There’s also a short-term risk of a reaction to the fluoride mixture if the child swallows too much during the procedure, which could cause stomach upset and pain, vomiting or headaches. We can avoid this by using precautions like dental dams and other isolation methods to prevent the child from ingesting it.

Using proper precautions and procedures, topical fluoride is a safe and effective way to give your child added protection against decay. Avoiding this destructive disease can help ensure they’ll enjoy good dental health for the rest of their lives.

If you would like more information on keeping your child’s teeth and gums healthy, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride Gels Reduce Decay.”





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