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Woodland Park, NJ
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3.25.19 DIY Braces?!?
Braces: The Low Down About Invisalign, Metal Braces, and DIY Teeth Straighteners
Braces – they aren’t just for teenagers anymore. And it seems like there has been a flood of new options being advertised recently. You’ve likely heard of Invisalign. You’ve likely seen the ads for teeth straightening products you can send away for through the mail, You’ve definitely seen traditional metal braces on countless teens, pre-teens, and even adults. With so many options, how do you know which one is best? We’re here to help! Here’s the low down about your options when it comes to braces.
What is Invisalign?
Invisalign is an orthodontic system that uses clear, removable, aligners to straighten teeth. The biggest appeal of Invisalign is that they are discreet, making them perfect for adults and active teens. Not only are they more discreet, they also allow you to keep eating your favorite foods, to stay active in the sports and activities you enjoy and they make it easier to care for your teeth during orthodontic treatment. We have been doing Invisalign in our office for years and it is a proven way to get your best smile.
What are Traditional Braces?
Traditional braces are the metal brackets and wires that come to mind when talking about orthodontics. The brackets are cemented to the teeth and the wire is adjusted to encourage the movement of the teeth. While often referred to as “metal” braces, there are also ceramic braces that are tooth colored and more discreet than traditional silver metal brackets that offer the same durability, strength and effectiveness as their metal counterparts.
Invisalign vs Metal Braces
Ultimately, the goal of all orthodontic treatment is to help you achieve optimal oral health. Straightening teeth is more than just looking good, crooked teeth and misaligned bites can impact not only how you feel about yourself, but can also impact your speech, your ability to chew and the function of your jaw. While both traditional metal braces and Invisalign help straighten teeth, one option will often be preferrable. Come in for a consultation to see which is best for you.
To determine if traditional braces or Invisalign is best for you, we will look at:
If teeth need to be removed
If you already have missing teeth
The severity of your crowding or misalignment of your teeth
The size and shape of your jaws
Whether or not you have issues with your bite
Oral hygiene habits
Presence of tooth decay and/or gum disease
Age/Maturity of patient
Length of time needed
All of these factors will lead the dentist or orthodontist to suggest the right type of treatment for you. And, working with a dental professional will not only help you choose well, they will be there every step of the way to ensure safety, health, and a successful outcome.
Do At-Home Clear Aligners Work?
Invisalign has made teeth straightening discreet and fast. There’s no wonder why people are excited about them. It’s also no wonder why competitors have come along offering cheaper, and “easier” options, such as at-home aligners. These aligners have you submit a mold of your teeth and send away for a series of teeth straightening aligners.
Sounds good right? Not so fast. The problem is that all of the evaluation done by a dentist, the evaluation that helps your dentist determine which braces treatment is best for you, is completely overlooked. Often patients end up purchasing a promise, but there is not a dental professional backing the experience to ensure it goes correctly. This can result in the aligners being ineffective and costly.
Worse, moving teeth through DIY methods, including dental trays and clear aligners, without dental supervision can be more harmful than good often leaving patients with bite problems they didn’t have before such as loose teeth not properly supported in the jaw bone.
A better solution? Come in for a check-up, get a professional diagnosis, and follow up with support and treatment to get the outcome you desire. Concerned about cost? Understandable, but don’t let it deter you. We can help you maximize any insurance benefits and we have lots of payment plan options. As always, give us a call at 973-256-0275 with any questions.
1.9.19 Questions About Dental Insurance
Well its been a while since I've written on this blog but I want to answer one question that has come up with the new year (Happy New Year by the way!). The question that pops up is about dental insurance and how it works. Here are the answers to some questions that patients bring up most.
The new year means new dental insurance for many of us. And while you might believe having and using dental insurance is important, you might also find understanding your dental insurance to be confusing. Deductibles, maximums, exclusions, waiting periods, networks, missing teeth clauses – it all might leave you scratching your head and asking the question, “How does dental insurance work?” Not to worry, we’re here to help decipher what all of it means so you can understand how dental insurance works and get the most out yours.
What Is Dental Insurance?
Dental insurance is a type of insurance that helps individuals pay for their dental care. While the specifics features of dental insurance plans differ, typically they will include coverage for preventive care like routine exams, x-rays and cleaning. Most plans will also include coverage for dental services like fillings, extractions, root canals, crowns, and in some cases orthodontics.
The plan you choose will dictate how much you will pay, how much the insurance company will pay and it might even dictate which dentist you need to visit. It’s important that you understand your coverage so that you can take advantage of your benefits and understand what you are responsible for.
Types Of Dental Insurance
So, where do you start? A good starting place is understanding what type of dental insurance plan you have. Most plans fall within one of the following categories:
Preferred Provider Organization (PPO): PPO plans have a list of dentists who will accept their plans, referred to as their provider network. Visiting an in-network dentist (a dentist on that list) will give you the greatest savings. Typically you can see a dentist who is out of network (not on the list) but you’ll pay more out of pocket.
(Dental) Health Maintenance Organization (DHMO, DMO or HMO): these plans provide a list of dentists who accept these plans for a set fee. But you have to see a dentist on that list to get the benefits
Discount Plan: again, there is a list of dentist who you can see but your coverage simply gives you a discount with them, the company providing the plan doesn’t pay anything for your care.
Once you know what kind of plan you have, you’ll want to find a dentist on the list. Nearly all plans will have a phone number or website to help you find a participating dentist.
How Does Dental Insurance Work?
Finding a dentist is just one piece of the puzzle, once you have one, you’ll likely want to know what you will have to pay when you go to the dentist. That will depend on the specifics of the plan. Most plans use a “benefit year,” to determine when the benefits are available for use. Your dental office will typically verify your dental insurance for an estimate of how much you will be expected to pay. After a visit to the dentist, a request for payment will be sent to your insurance company; this is called a claim. The insurance company will review and process the claim and then explain how the claim was paid with an EOB, or explanation of benefits.
Ultimately, your financial obligation is based on the treatment you receive and the specifics of your plan some of which might include the following:
Deductibles – an amount you must pay before the insurance company will pay anything.
Coinsurance – once the deductible is met, you may have to pay a percentage of the cost of covered treatment, for example you may have to pay 50% of a major procedure.
Co-pay – a fixed cost for a certain procedure
Annual Maximum – the maximum amount the insurance company will pay during the benefit year. Once that maximum is reached during a benefit year, you pay all additional expenses.
Preauthorization – some plans may require approval from the insurance company before treatment is done in order for the plan to pay benefits.
Exclusions – services and/or products that insurance won’t cover
Waiting period – some plans won’t cover certain procedures until a certain amount of time has passed. These are usually major procedures like teeth replacement or crowns
Limits – many plans have time limits for certain procedures. For example, many plans will cover two cleanings a year, as long as six months has passed between them. Limits may also apply to the frequency of x-rays and to treatments on a specific tooth.
Pre-existing conditions – some plans won’t cover conditions that you had before signing up for their plan, meaning you will be responsible for paying for treatment for that condition.
As always, feel free to contact me anytime with any questions or call Donna, our office manager, who can call your insurance company or answer specific questions. Our number is 973-256-0275.
7.20.18 Fact or Fiction? The Tongue Is the Strongest Muscle in the Body
Here is a reprint from an article I saw in Scientific American that I found interesting:
It can bend, it can twist, it can suck, it can cup. The tongue is an essential, often playful part of human anatomy. Many of us grew up believing the assertion that the tongue is the strongest muscle in the body. But is it really?
The short answer is no. But the explanation is not as straightforward as you’d think. We asked a few tongue experts (yes they do exist) why the myth has been so easy to swallow.
Maureen Stone, of the University of Maryland School of Dentistry, speculates that the myth of the tongue’s strength arose from its amazing stamina even in precision tasks like eating and speaking. “When’s the last time your tongue was tired?” she asks. “If you don’t have any disorders, the answer is probably never.” Stone says the tongue’s tenacity springs from the way it is built—with lots of similar bits of muscle that can each perform the same task. “It doesn’t fatigue,” she says, “because there’s a lot of redundancy in the muscle architecture. You simply activate different muscle fibers and get the same result.”
Stephen Tasko, a speech scientist at Western Michigan University, says that the question of whether the tongue is the strongest muscle in the body is itself misinformed. The soft patty of flesh we call the tongue is not just one muscle, it’s a conglomeration of eight separate muscles. Unlike other muscles, such as the bicep, tongue muscles don’t develop around a supporting bone. Rather, they intertwine to create a flexible matrix, forming what is called a muscular hydrostat; this structure is similar to an octopus' tentacles or an elephant’s trunk.
Four muscles in the matrix, called the extrinsic muscles, anchor the tongue to structures in the head and neck. One muscle holds on to the base of the skull, another connects to a bone in the throat, there is a muscle that grabs on to the lower jaw and another wrapped around the palate. These propel the tongue from side to side, front to back and up and down.
The rest of the muscles make up the tongue’s body. They’re what give it the ability to contort into endless arrays of shapes and postures. They allow it to lengthen, shorten, curl, flatten and round, and they provide shape to assist in speaking, eating and swallowing.
Because the tongue is all muscle and no bone, it is very supple, boasting a huge range of motion and shape while preserving its volume. “It’s kind of like a water balloon,” says Tasko. “If you deform it in one place, it’s going to pop out in other spots.” Tasko believes the myth of extraordinary strength has persisted because of the tongue’s tireless flexibility. "We all know that you can do all kinds of gymnastics with your tongue,” he says, “because it always seems to be going, and it's highly agile.” He adds: “I think maybe those are construed as having something to do with strength."
By sticking a pliable air-filled bulb into a subject’s mouth, scientists can measure the maximal pressure the tongue can exert on an object. This device, called an Iowa oral performance instrument, is placed on the tongue and subjects are asked to push it toward the roofs of their mouths as hard as they can. Scientists also use this bulb to measure endurance, or how long the tongue can hold a certain posture. Such measurements have given the lie to the myth, because you’re not really measuring muscles but muscle systems. But what, then, is the strongest muscle system in the body? The answer turns out to be complicated and depends on how muscular strength is defined—but no matter, the tongue doesn’t win under any criteria.
There are lots of ways to measure strength. One is brute force, in which case biggest is best. All skeletal muscles are bundles of many individual fibers that contain small force generating structures called sarcomeres. “Generally speaking, more muscle tissue means a larger total number of sarcomeres, which means greater maximum force generation,” Tasko says. That means the largest muscles—the quadriceps on the front of your thighs and the gluteus maximus on your rear—produce the most force.
Muscle size and raw force aren’t everything though. Muscles work by pulling on bones, which act as levers that convert muscular contractions (small but powerful movements) into large motions—think: curling a dumbbell. Your bicep pulls on the bones in your forearm to lift the dumbbell. Because your forearm is long and the bicep pulls on it right near the elbow, says Khalil Iskarous, a linguist at the University of Southern California, the bicep has to pull with a lot of force to move your hand up to your shoulder. Your jawbone, in contrast, is a much shorter lever. Because of this, the masseter, the main muscle in your jaw, is also a contender for strongest muscle in the body.
Or maybe it’s not about force at all, but rather about overall work done in the course of a lifetime. By that measure, the hardest working muscle in your body is the one that’s pump-pump-pumping 24/7 to keep your blood flowing round and round, including to all the other muscles: your heart.
The tongue may not be as strong as the glutes, jaw or heart but strengthening it may still be useful. Tasko says there is some evidence suggesting that strengthening exercises may benefit people who have trouble swallowing, such as those recovering from stroke. Some speculate that strengthening the tongue may even improve speaking abilities or help treat speech pathologies. Tasko warns, however, that these assertions are controversial and need further testing.
But one thing’s certain: the tongue is definitely not the strongest muscle in the body. Maybe people continue to believe in its power simply because the tongue is weird; it’s literally inside your face, and people like superlatives. “People want to attach some kind of ‘est’ to it,” Iskarous says. “‘Strongest’ or this or that—and that’s maybe what stuck.”
4.11.18 April is Oral Cancer Awareness Month
Oral cancer is a cancer of the mouth and throat which usually consists of a red or white patch or ulcer which is present more than 10-14 days. It is usually symptom free and due to this fact often not found until later stages. Historically the death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development. Most of my patients say no dentist has ever pulled out their tongue to check for it. When diagnosed early the prognosis is much better. The examination is very simple and without any equipment other than a piece of gauze, a light and a mirror. Most lesions can be simply biopsied in a mostly pain free manner for a gold standard diagnosis. Close to 49,750 Americans will be diagnosed with oral oropharyngeal cancer this year. It will cause over 9,750 deaths, killing roughly 1 person per hour, 24 hours per day. Of those 49,750 newly diagnosed individuals, only slightly more than half will be alive in 5 years. (Approximately 57%) This is a number which has not significantly improved in decades. (The survival number at 5 years from diagnosis was for many decades about 50%, so 57% is an improvement over the last ten years. However this is due to the increase of HPV16 caused cancers which are more vulnerable to existing treatment modalities, conferring a significant survival advantage. So a change in the etiology, not improved early discovery or treatments; which are relatively unchanged from a decade ago, are not the sole cause for improvement.) The death rate for oral cancer is higher than that of cancers which we hear about routinely such as cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid.
he demographics of those who develop this cancer have been consistent for some time. While historically the majority of people are over the age of 40 at the time of discovery, it is now occurring more frequently in those under this age. Exact causes for those affected at a younger age are now becoming clearer in peer reviewed research, revealing a viral etiology (cause), the human papilloma virus number 16. There are also links to young men and women who use conventional “smokeless” chewing or spit tobacco. Promoted by some as a safer alternative to smoking, it has in actuality not proven to be any safer to those who use it when referring to oral cancers. Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers, pancreatic cancer, periodontal disease, and the chronic infections that it produces may even link it to heart disease as well. The gains against lung cancers may occur, but there will be new losses in other areas. The jury is out on other new smokeless tobacco dissolvable products, and until their use has acceptable research behind it we recommend avoiding it.
It is also now confirmed that in a younger age group, including those who have never used any tobacco products, have a cause which is HPV16 viral based. The human papilloma virus, particularly version 16, has now been shown to be sexually transmitted between partners, and is conclusively implicated in the increasing incidence of young non-smoking oral cancer patients. This is the same virus that is the causative agent, along with other versions of the virus, in more than 90% of all cervical cancers. It is the foundation’s belief, based on recent revelations in peer reviewed published data in the last few years, that in people under the age of 50, HPV16 may even be replacing tobacco as the primary causative agent in the initiation of the disease process.
From a gender perspective, for decades this has been a cancer which affected 6 men for every woman. That ratio has now become 2 men to each woman. Again, while published studies do not exist to draw finite conclusions, we will probably find that this increase is due to lifestyle changes, primarily the increased number of women smokers over the last few decades. It is a cancer which occurs twice as often in the black population as in whites, and survival statistics for blacks over five years are also poorer at 33%, versus 55% for whites. As in the above examples, it is unlikely we will find a genetic reason for this. Lifestyle choices still remain the biggest cause. These published statistics do not consider such socio-economic factors as income levels, education, availability of proper health care, and the increased use of both tobacco and alcohol by different ethnic populations, but all these factors likely play a role in who develops the disease.
As always, if you have a question or concern, give us a call at 973.256.0275 and we will be happy to answer any questions or make an appointment for an evaluation.
2.6.18 National Children's Dental Health Month 2018
Every February the American Dental Association (ADA) sponsors National Children’s Dental Health Month. The goal is, unsurprisingly, to raise awareness about the importance of kids’ oral health.
We all know that it’s critical to take good care of our children’s teeth, and teach them how to keep their smiles strong and beautiful. But any parent who has wearily tried to convince a toddler to brush their teeth for the recommended two minutes also knows, it can be hard to engage the little ones in their dental care chores. Sometimes we even wonder whether it’s worth all the fuss to care for teeth that will soon fall out and be replaced with a permanent set.
But those baby teeth matter. Experts say that if kids lose their teeth prematurely, their permanent teeth can come in crooked or otherwise compromised. Kids who have cavities in their baby teeth will almost certainly have decay in their permanent teeth.
Making Dental Care Fun
Kids can get excited about brushing if they really understand the reasons behind caring for their teeth. But explaining these reasons carefully and reasonably often just doesn’t click with kids. Sometimes they need to prove it to themselves with activities like simple science experiments (not on their own teeth, of course!) And sometimes visual aids can capture a kid’s attention and transform him or her into a dedicated dental care advocate.
Thankfully, the internet is filled with oral health resources for children. Among the best that we found are:
The American Dental Association has a slew of free dental care goodies that parents, teachers and dentists can use to capture kids’ interest and educate them on proper dental care. There are activity sheets, lesson plans, information, puzzles and games. You can download the full packet in English here and in Spanish here. Or you can browse all of their National Children’s Dental Health Month resources here
The National Education Associate offers a super set of dental-oriented science experiments worksheets, which you can download here. Highlights include a dramatic demonstration of an acid attack on bones (which are rich in calcium, just like teeth) that can help kids to visualize what happens to their teeth when they consume sugary foods and beverages. Other experiments included in the set will convince kids of the magical powers of dental floss and fluoride.
Renaissance Dental offers a downloadable booklet of fun dental facts, which you can access here. A warning for the super- sensitive: a few of the facts may seem a little gross (especially to grownups). Here’s one:
- On a daily basis, your mouth is home to over 100,000,000 micro-creatures who are swimming, feeding, reproducing, and depositing waste in your mouth. Makes you want to brush your teeth, doesn’t it?
Well … yes, it does, and it also makes me want to gargle with boiling water.
You are, of course, the best judge on your kids’ likely reaction to knowing the nitty-gritty details about the interesting things that are happening in his or her mouth. Though chances are good that your kid will prefer the icky facts to safer but equally interesting ones, such as:
- We use our teeth to bite and chew, but did you know dolphins only use their teeth to grasp? Dolphins can’t chew, because dolphins’ jaws have no muscles.
- Dental floss was first manufactured in 1882. If you floss once a day, you will use about 5 miles of floss over your lifetime! Dental floss isn’t just for teeth—a prison inmate in West Virginia braided floss into a rope, scaled the prison wall and escaped.
- If you brush your teeth twice a day for two minutes each time, you will brush your teeth for about 24 hours each year, or 76 days over the course of your life! All this brushing will use about 20 gallons of toothpaste.
For video resources, you can browse through PBS’ toothy clips here.
Last but not least, teachers and parents will also find a wealth of educational resources at the Open Wide Tooth School, right here.
Happy National Children’s Dental Health Month!
If you’d like more information about children's dental health call us at 973-256-0275.
2.5.18 The Latest in Professional Teeth Whitening: Introducing Our In Office Zoom!
Why Philips Zoom in-office professional whitening?
We've used all types of whitening systems and this is truly the latest and greatest. It uses the latest in LED technology and most effective whitening gel. The big difference is the desensitizing gel that we place in the take home trays that you go home with which will minimize or, in most cases, eliminate sensitivity. This really sets the latest Zoom whitening apart from all other brands and older versions of Zoom.
Advanced technology, proven results
It’s the name asked for by more patients than any other professional whitening brand1 – and for good reason. Only Philips Zoom WhiteSpeed delivers maximum results, advanced LED light-activated technology and variable intensity settings. Plus, it’s clinically proven to whiten teeth up to eight shades in one procedure.
Breakthrough two-layer technology
Thanks to an innovation in application methods, Philips Zoom QuickPro requires only minimal chair time for noticeably whiter results2. You apply the 20% hydrogen peroxide whitening varnish, followed by a sealer layer that dries in seconds and locks the varnish in place. A half-hour later, the patient wipes or brushes off the thin film to reveal a brighter smile!
Taking on the toughest stains
You now have a specific protocol for treating patients with severe tooth discoloration. Philips Zoom Ultimate Protocol combines Philips Zoom WhiteSpeed and Philips Zoom NiteWhite take-home for exceptional results. In a case study, nine patients experienced an average improvement of 11 VITA shades3 from this innovative whitening protocol.
1 In the U.S.
2 Up to four shades. Actual results may vary.
3 Case study may not be representative of results. Actual results may vary.
10.18.17 Your Dental Benefits: Use Them or Lose Them!
When it comes to dental benefit plans, millions of people each year are ringing in the New Year leaving money on the table. According to the National Association of Dental Plans, only 2.8% of people with PPO dental plan participants reached or exceeded their plans annual maximum. Many people also have Flexible Spending Accounts, which help pay for dental and medical care with pre-tax dollars.
Whether you’re paying for dental care through a benefits plan or using an FSA, your current plans will most likely run out on December 31. Don’t let your hard-earned dental dollars go to waste. Here is a breakdown of what these benefits are, when you need to use them by and how to make the most of your benefits.
Dental Benefit Plans
Many people with dental benefits get them through their employers, though individual plans are also available through Health Insurance Marketplaces established by the Affordable Care Act. Remember, when you buy a plan you and your employer are paying some premium – upfront dollars – that are wasted if you don’t see your dentist.
When You Need to Use Them By
Many insurance companies have a benefit deadline of December 31, and this means that any of your unused benefits don’t roll over into the New Year for most dental plans. Still, some plans may end at different times of the year, so check your plan document or ask your employer to be sure.
Tips for Making the Most of Your Plan
The key with this type of coverage is to take advantage of any benefits before they expire for the year.
- Prevention is better than cure both for your health as well as your pocketbook. Most plans typically pay 100% for preventive visits, so if you have not had one yet, this may be a good time to schedule one.
- Start thinking about using your coverage early. During a dental appointment that's over the summer or in the fall, talk to your dentist about what your dental needs are and what treatment you might need before the end of the year. (For example, a back-to-school appointment is a great time to bring this up.) Make any upcoming appointments early so you can take care of them before the holidays.
- Once you've determined what your dental needs are, work with your dentist and benefits provider to figure out what is covered. Often, your dentist's office will look into this information for you. You can also call your plan using the 800 telephone number on your identification card, or go to their website for information.
Flexible Spending Accounts
A Flexible Spending Account (FSA) is an account you can set up through your employer. During open enrollment, you choose how much money to put into this account, and a portion of this amount is deducted from each paycheck pre-tax. FSAs generally cover services or products that help keep your mouth healthy, including cleanings, braces needed for dental health reasons, benefit plan co-pays, dentures and more.
Many FSAs work like debit cards, and you can use that card to pay for various medical and dental expenses, including some products available at your local drugstore.
When You Need to Use Them By
Generally, you must use the money in an FSA within the plan year by December 31. However, your employer may offer one of two options that give you a little more time to spend what’s in your account:
- Some provide a grace period of up to 2½ extra months to use the money in your FSA.
- Others may allow you to carry over up to $500 per year to use in the following year.
Whether it’s at the end of the year or a grace period, you lose any money you haven’t spent. Check with your employer or FSA administrator to see what your plan allows.
Tips for Making the Most of Your FSA
- Plan carefully so you don’t put more money in your account than you will spend within a year on dental or other health care costs.
- As with dental benefit plans, talk with your dentist in the summer or fall during regular appointments to see if you have any needs or procedures that need to be completed. You may be able to use your FSA to pay for these needs or use your FSA to pay any associated co-pays or co-insurance.
- Contact your FSA administrator for a list of covered services and products (usually referred to as eligible expenses). However, most FSA accounts cannot be used for cosmetic procedures and services like whitening, veneers or cosmetic braces.
- Make any remaining dental appointments as soon as you know you need them to ensure your FSA dollars can be used in time.
One other option is our in office dental savings plan which will get you one free cleaning per year and 20% off treatment including Invisalign and cosmetic treatments! Call us today for details. 973-256-0275.
8.24.17 Emergency Dental Items That All Sports Programs Need to Have on Hand
With the start of school and fall sports coming soon, I created a checklist of items all sports programs (and the teams that I coach for my own children) should have on hand at each practice or game. Items should be given to each team and brought every time the team meets--not just games. As we all know, accidents happen any time and preparedness is the key.
Be safe this season!
6.5.17 Antibiotic Prophylaxis--Who Needs It?
Antibiotics usually are used to treat bacterial infections. Sometimes, though, dentists or physicians suggest taking antibiotics before treatment to decrease the chance of infection. This is called antibiotic prophylaxis. During some dental treatments, bacteria from the mouth enter the bloodstream. In most people, the immune system kills these bacteria. There is concern, though, that in very select patients, bacteria from the mouth can travel through the bloodstream and cause an infection somewhere else in the body. Antibiotic prophylaxis may offer these people extra protection
WHO MIGHT BENEFIT FROM ANTIBIOTIC PROPHYLAXIS?
People with certain heart conditions may be at increased risk of developing infective endocarditis (IE)—an infection of the lining of the heart or heart valves. To protect against IE, or limit its effects should the infection develop, the American Heart Association suggests that antibiotic prophylaxis be considered for people who have1 -an artificial heart valve or who have had a heart valve repaired with a prosthetic material; -a history of IE; -a heart transplant that develops a valve problem; -certain heart conditions that are congenital (present from birth), including n unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits; n a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure; n any repaired congenital heart disease with residual defect at the site or adjacent to the site of a prosthetic patch or prosthetic device.
WHAT ABOUT PEOPLE WHO HAVE HAD HIP OR KNEE REPLACEMENT SURGERY?
The American Dental Association does not routinely recommend antibiotic prophylaxis for people who have had a hip, knee, or other joint replaced.2 People who have had joint replacement surgery and have a weakened immune system—meaning that they are less able to fight infections—should talk to their dentist and their orthopedic surgeon to see if antibiotic prophylaxis is recommended. Conditions such as diabetes, rheumatoid arthritis, or cancer and medications such as steroids. and those used in chemotherapy can affect your ability to fight infections.
WHY IS ANTIBIOTIC PROPHYLAXIS NOT USED FOR EVERY PATIENT?
Antibiotic prophylaxis is not right for everyone and— like any medicine—antibiotics should only be used when the potential benefits outweigh the risks of taking them. For example, consider that infections after dental treatment are not common and that, in some people, antibiotics can have side effects. Side effects associated with taking antibiotics include stomach upset, diarrhea, and allergic reactions, some of which can be life threatening. In addition, using antibiotics too often or incorrectly can allow bacteria to become resistant to those medications. Therefore, it is important to use antibiotic prophylaxis in only those people at greatest risk of developing an infection after dental treatment.
As always, call Dr. Ruggiero if you have any questions at 973-256-0275.
4.26.17 Is Fluoride Bad For Toddlers?
A Little Background on Fluoride
Fluoride is an effective way to prevent and even reverse the early signs of tooth decay. It makes the tooth structure stronger, so teeth are more resistant to acid attacks.
Many of us take in fluoride naturally through the water we drink, but not all parts of the country require that fluoride be part of the drinking water, and more and more families are choosing bottled water, which in most cases does not contain fluoride like tap water does.
Groups like ADA have long recommended brushing teeth and seeing a dentist as early as age 1, but parents tend to be undereducated in this area or they give in to toddlers who do not like brushing their teeth.
New Research on Fluoride
The 2014 change by the American Dental Association brought its recommendation in line with the American Academy of Pediatrics, which has long suggested the use of fluoride toothpaste as soon as teeth begin to show.
The change also came after research showing an increase in cavities among preschool age children noted by the Center for Disease Control. In some cases, the problem was so bad that children needed to be placed under general anesthesia to have cavities filled in half of their baby teeth or more.
The hope is that introducing fluoride toothpaste into the equation earlier will help reduce the number of cavities in young children. The ADA recommends that children spit out the toothpaste after it’s applied to their teeth to avoid developing fluorosis, a condition that results in a tooth’s enamel changing color due to too much fluoride exposure. Of course, this is easier said than done with a small child. Starting early and reinforcing good habits will help put them on a path toward success.
In some cases fluoride exposure has also been linked to ADHD and other neurological conditions when too much of it is ingested. Swallowing toothpaste here and there is not a big deal, but over time it could lead to more serious problems if the habit is not corrected.
What’s Best for Your Child?
Still wondering “is fluoride bad for toddlers“? Even though baby teeth do eventually come out, it can be years before that happens so it’s important to get cavities taken care of at a young age. The pain associated with cavities can often be mistaken for teething; don’t let that deter you from taking your child to a dentist as soon as he or she starts talking about any kind of mouth pain.
As far as fluoride, the key is finding the right balance between getting your child enough of it to prevent tooth decay and using so much that it puts him or her at risk for other issues.
Before deciding on whether to start using fluoride toothpaste, you should understand how much fluoride your child is already getting. Do you have it in your drinking water? If you don’t know the answer to that question, a water test or call to your local water authority can help you find it.
Diet is another factor to consider. If your child enjoys soda or other sugary snacks, a little extra fluoride may be necessary to combat the effects sugar can have on young teeth.
If you are still in doubt, be sure to ask your dentist at your next checkup. Your dentist will examine your child’s teeth and take into consideration environmental factors before making an informed decision about whether you should begin using fluoride toothpaste with your toddler. As always, feel free to call us with any questions at 973-256-0275 or make an appointment for a free consultation.
4.3.17 More History??
In keeping with my last blog post about Painless Parker, I want to talk about the history of dentistry and how your smile can affect self confidence and how your self confidence can affect how you are viewed over time. Those of you who know me know I like to use examples and metaphors to describe dental conditions. For this blog, I will go back in time because history gives us some good examples of how your smile can affect how others view you. Ever wonder why we rarely catch a glimpse of the teeth of our founding fathers, or of anyone depicted in the art of that era? It was hardly customary to smile while snapping selfies in the 1700’s. That’s likely because artists could take up to a year to finish a portrait (imaging the cheek cramps holding a smile that long!). Plus, a face displaying 18th century dental work was nothing to immortalize on canvas.
George Washington’s was no exception. He suffered poor dental health his entire adult life. He lost an average of one tooth a year for decades until, at his inauguration, he had but one tooth remaining. Throughout the years, including those spent fighting the British, General Washington regularly ordered dental appliances, tooth scrapers, and painkillers in his battle for oral health. But alas, the revolution’s greatest general was destined lose the war to save his smile.
Paintings of young Washington illustrate a handsome man with a natural and well-proportioned facial bone structure. Images painted during his Presidential years, however, disclose the underlying dental turmoil Washington was enduring. If loosing his teeth was not painful enough, the devices built to replace them were almost worse. The term dental appliance today describes several types of elegantly crafted, perfectly fitted devices that fill voids, realign bites, and restore smiles. In 1776, however, the contraptions George suffered were more the size, weight, and complexity of an actual household appliance. By the time Washington became our nation’s first President, his dentures were a heavy construction of lead, springs and gold wires, holding together teeth fashioned from bone and ivory, along with real teeth taken from cows, donkeys, and even slaves (to whom he paid the customary fees for “donated” teeth).
Not only were these teeth somewhat difficult to look upon, their heavy springs required Washington to clinch his jaw in order to close his mouth. So, not only did the heavy dentures cause is lips to protrude, over time they also caused his jaw to become heavy and misshapen. The face we have come to revere as that of the “Father of our Country” was shaped, in part, by the painful personal battle so few knew he was fighting. As one might understand, these dental problems made President Washington self-conscious and reticent to speak in public; Imagine the great speeches never delivered because of the extraordinary effort required for him to even talk.
Contrary to folklore, no evidence affirms that Washington ever gave orders or made speeches through teeth carved from wood. This myth likely started because Washington enjoyed a glass of wine at dinner and, over the years, the red wine stained the cracks in his ivory teeth, creating patterns that resembled wood grain.
These two centuries later, the art of restoring dental health brings confidence and comfort to millions. From simple cosmetic procedures that enhance smiles, to full restorations of entire sets of teeth, We here at Woodland Park Dental are helping patients live life to the fullest with excellent oral health. If ever you find yourself shy to smile in a selfie, or nervous to speak in public because of dental concerns, please let us help. Don’t rob yourself and those you love of the joy of sharing smiles with you.
3.6.17 National Dentist Day: Painless Parker
To celebrate National Dentist Day (definitely not the most popular holiday!?!?) Just for fun I will give you a brief history of one of our profession's lesser liked "dentists" with an interesting story. Having a tooth pulled in the early 1900s was anything but pleasant--usually done in barber shops where the barber-surgeon gave you a cut and shave and pulled a tooth. Until "Painless" Parker came into town. You’d climb up into the back of a traveling caravan, surrounded by a booming brass band, sparkling costumed women, and next to a bucket of pulled teeth carried by a dapper gentleman with a goatee. In time with the band's cheerful tune, out would come your tooth, guaranteed to be a painless—and even entertaining!—extraction.
Well, not quite. Victims of this ruse, run by the famed dentist Painless Parker and his Dental Circus, often left the appointment hoarse from their screams of pain. And at the Kornberg School of Dentistry's Historical Dental Museum Collection at Temple University in Philadelphia, you can pay homage to the dentist's colorful, if misleading, claims by visiting a selection of his grisly artifacts—from a bucket of teeth to the strung-tooth necklace and advertisements he used to lure in customers.
Edgar Randolph “Painless” Parker began his dental practice in 1892, after his graduation from the Philadelphia Dental College (now the Temple University Maurice H. Kornberg School of Dentistry), when dentistry for widespread tooth decay was still emerging as a profession. According to the college’s current dean, Dr. Amid Ismail, Parker was a terrible student and only graduated because he pleaded with his dean to pass him. The dean did, and Parker moved home to Canada to start work as a dentist.
But there was a problem. At the time, it was considered unethical in the profession to solicit patients, so Parker found that after six weeks, he still hadn’t seen a single client. He decided to toss ethics to the wayside and start an advertising campaign. In exchange for a new set of dentures, Ismail told Smithsonian.com, the desperate dentist bartered with a sign maker for a placard that read “Painless Parker.” His business idea was deceptively simple: He would inject patients with a solution of watered-down cocaine and pull their teeth. The 50-cent extraction would be painless, he said, or he'd pay the patient $5.
When Parker first became a dentist, most offices (called dental parlors at the time) were incredibly unsanitary and the dentists there were usually unlicensed. People didn’t want to go, so they tended to treat themselves at home with narcotic-laced over-the-counter medication. Parker began his practice to take advantage of the current dental atmosphere—lack of trained practitioners and patients’ fears of pain. He concocted the cocaine solution, but it didn’t always work—sometimes he just gave his patients a glass of whiskey instead.
But Parker wasn't content to stop there. Donning a top hat, coattails and a necklace he made out of teeth (supposedly the 357 teeth he pulled in one day), he partnered with William Beebe, a former employee of P.T. Barnum, to create a traveling dental circus in 1913. At the show, Parker would bring a pre-planted person out of the audience and pretend to pull out a molar, showing the audience an already-pulled tooth he was hiding as evidence that the extraction was completely painless. Then, accompanied by a brass band, contortionists and dancing women, real patients would climb into the chair for the same procedure.
While he pulled the tooth out, still for 50 cents an extraction, Parker would tap his foot on the ground to signal the band to play louder—effectively drowning out the patient’s pained screams. He still used the cocaine solution—but instead of injecting it to numb the mouth, he'd squirt it into the cavity—and that only worked sometimes, if at all. Still, Parker managed to become popular. Dental patients and visitors liked the distraction of the brass band and the rest of the circus. Thanks to the band, no one heard the moans—and everyone but the hapless patient assumed the treatment didn’t hurt a bit.
But when Parker moved to California, he left a horde of angry, hurting patients in his wake. The man who duped his aching patients was detested by his colleagues, too—the American Dental Association even called him “a menace to the dignity of the profession.”
“Any positive patient stories are likely to be fake,” Ismail said. “Painless Parker was sued many times and lost his dental licenses in several states. He was a showman more than a real dentist, and he cared more about providing expensive dental care than care that would actually benefit the health of his patients.”
He legally changed his name to Painless Parker in 1915, Ismail said, opening up a chain of about 30 Painless Parker Dental Clinics on the west coast. The clinics hawked dental services and a line of dental care products—the first of their kind. Though Parker was a huckster and, arguably, a con man, his contribution to the dental world is undeniable. Not only was he the first to openly advertise and open a chain of clinics, but in a backwards way, he can also be considered a founding father of good dental practices. Interesting reading but not necessarily good for the cause of ethical dentists.
Read more: http://www.smithsonianmag.com/travel/remember-when-pulling-teeth-was-fun-180960448/#UbAecZI6O04gGSVU.99
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1.23.17 Dental Intraoral Scanners--No More Impressions?
Traditional impression materials have served dentists and their patients quite well for decades. Does it make sense to replace the goop with microchips? Is the new technology better? Will the added initial expense be more cost effective in managing the continued pressure on dental fees? The answer to these questions is a resounding yes, yes and yes.
Dentists who have adopted the technology are universally pleased, reporting better accuracy, faster seat times, and in some cases, lower lab fees. But, let’s be clear. Those are subjective opinions. Here are some of the facts about intra oral scanners and their advantages.
Intraoral scanners are camera like devices which take many photos of the teeth and gums and "stitch" them together to form a digital representation of the mouth. They can be used for crowns, implants, invisalign orthodontics, and nightguards. They are more accurate, faster, and easier. They will make lab work fit better and be faster. That means less time with a temporary for the patient. No goop means no more gagging for the patient. Definitely a win-win for patients, dentists and lab technicians.
These devices are a definite step forward. Currently, they are not well known by dentists. The advantages are quite evident. It is unnecessary to place impression material in the mouth. This will eliminate the known uncomfortable sensations, occasional peculiar taste, and undesirable associated mess. The digital information can be relayed immediately to the laboratory. The procedure has the possibility of reducing the unpredictability of standard impression-making.
We are pleased to have one of the best intraoral scanners in our office to help us be the best practice around. Call us with any questions.
12.21.16 Christmas Blog (Could this be my last post for 2016?!?)
Remember the song “All I want for Christmas is my Two Front Teeth?”
Did you know this novelty Christmas song was written in 1944, by Donald Yetter Gardner? A music teacher in New York, one day Mr. Gardner asked his second-grade class what they wanted for Christmas. He noticed that almost all of the students had at least one front tooth missing as they answered in a lisp! According to Wikipedia, Gardner wrote the song in 30 minutes. In a 1995 interview, Gardner said, "I was amazed at the way that silly little song was picked up by the whole country.” The song was published in 1948 after an employee of Witmark music company heard Gardner sing it at a music teachers conference. This is the kind of missing tooth story even a dentist can delight in!
When you picture a reindeer smiling, what do you picture?
Would it surprise you to learn that reindeer only have teeth on the bottom of their mouths? On the top, they have a hard, bony plate to help grind their food. So chances are, the big toothy grin you’re picturing isn’t really what a reindeer smile looks like — unless they’ve had some implants! And Rudolph the Red-nosed Reindeer probably wasn’t a regular patient for his dentist friend Hermey in the children’s Christmas classic.
“All I Want For Christmas is You” — Mariah Carey has a secret for a straight-looking smile
One of our favorite Christmas songs is “All I Want for Christmas is You,” and most of us think of Mariah Carey as having a picture-perfect smile. But did you know her teeth are not perfectly aligned? Instead, she has a secret to LOOKING great in pictures! When she smiles, she lets photographers take most of her pictures from her best angle, her right. One of my favorite instagram accounts is one which features celebrity before and after smiles (but then again, I am a little teeth obsessed!!).
From our family to yours we wish you a very happy holiday season and a healthy and happy 2017.
11.22.16 Part 3 of a 3 Part Series on TMJ Disorders
Treatment of a TMJ Issue
In some acute cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor may recommend a variety of treatment options, often more than one to be done at the same time. Call us for an evaluation if you are exhibiting any of the signs or symptoms of a TMJ issue.
Along with other nonsurgical treatments, these medication options may help relieve the pain associated with TMJ disorders:
- Pain relievers and anti-inflammatories. If over-the-counter pain medications aren't enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naprosyn, are a mainstay of treatment.
- Tricyclic antidepressants. These medications, such as amitriptyline, used to be used mostly for depression, but now are sometimes used for pain relief.
- Muscle relaxants. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.
Nondrug therapies for TMJ disorder include:
- Oral splints or mouth guards (occlusal appliances). Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well-understood.
- Physical therapy. Treatments might include ultrasound, moist heat and ice — along with exercises to stretch and strengthen jaw muscles.
- Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails. This is one of the most commonly overlooked but important aspects for the success of your treatment.
Surgical or Other Procedures
When the above methods don't help, your doctor might suggest procedures such as:
- Arthrocentesis. Arthrocentesis (ahr-throe-sen-TEE-sis) is a minimally invasive procedure that involves the insertion of small needles into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.
- Injections. In some people, corticosteroid injections into the joint may be helpful. Infrequently, injecting botulinum toxin type A (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.
- TMJ arthroscopy. In some cases, arthroscopic surgery can be as effective for treating various types of TMJ disorders as open-joint surgery. A small thin tube (cannula) is placed into the joint space, an arthroscope is then inserted, and small surgical instruments are used for surgery. TMJ arthroscopy has fewer risks and complications than open-joint surgery does, but it has some limitations as well.
- Modified condylotomy. Modified condylotomy (kon-dih-LOT-uh-mee) addresses the TMJ indirectly, with surgery on the mandible, but not in the joint itself. It may be helpful for treatment of pain and if locking is experienced.
- Open-joint surgery. If your jaw pain does not resolve with more-conservative treatments and it appears to be caused by a structural problem in the joint, your doctor or dentist may suggest open-joint surgery (arthrotomy) to repair or replace the joint. However, open-joint surgery involves more risks than other procedures do and should be considered very carefully, discussing the pros and cons.
If your doctor recommends surgery, be sure to discuss the potential benefits and risks, and ask what all your options are.
Complementary and alternative medicine techniques may help manage the chronic pain often associated with TMJ disorders. Examples include:
- Acupuncture. A specialist trained in acupuncture treats chronic pain by inserting hair-thin needles at specific locations on your body.
- Relaxation techniques. Consciously slowing your breathing and taking deep, regular breaths can help relax tense muscles, which can reduce pain.
- Biofeedback. Electronic devices that monitor the tightness of specific muscles can help you practice effective relaxation techniques.
As you see, treatment of a TMJ problem is usually very straightforward but there are many facets to the approach and oftentimes requires a combination of approaches. Call us today at 973-256-0275 for a consultation if you are experiencing signs or symptoms of a TMJ problem.
11.17.16 Part 2 of a 3 Part Series on TMJ Disorders
The temporomandibular joint, or TMJ, is the hinge between the upper and lower jaw. When this hinge isn’t working correctly, the jaw tends to lock up, causing a throbbing pain.The jaw muscles are made out of a complex system of ligaments, muscles, discs, and bones. Individuals who are suffering from TMJ tend to hear a clicking sound in their jaw. Some of the more common symptoms associated with TMJ include earaches and headaches, pain when you open your jaw especially when yawning or eating, jaws that feel like they are stuck in one position, and tenderness in the jaw muscles.
Relief from Pain With TMJ Therapy
If your jaw isn’t damaged, then there are certain noninvasive treatment options that you can employ to manage the pain. Abstaining from chewing gum and eating certain foods that require rigorous chewing like bagels or big sandwiches or tough foods like steak can be your first line of defense when it comes to alleviating pain and tenderness. Stretching exercises and stress management, coupled with the application of cold or warm compresses on the jaw can help ease mild forms of TMJ. Controlling muscle tension in the shoulders and upper back is an important aspect of the treatment.
For many cases, a TMJ dentist may require you to wear a jaw splint or a mouthguard if tooth grinding is the cause of your jaw pain. Ultrasound treatments, as well as physical therapy, can also be coupled with other treatments as a form of comprehensive treatment. Generally a mouthguard worn nightly is a proper solution and approximately thirty percent of adults in our practice have a TMJ issue requiring a mouthguard. As always, call with any questions or to set up an appointment for a free consultation and evaluation.
11.10.16 Part 1 of a 3 Part Series on TMJ Disorders
Top 5 Signs/Symptoms of a TMJ Disorder (TMD)
TMD is a condition that typically affects adults between the ages of 20-40 years old although I have seen patients suffering these issues as young as 11 and as old as 86. Many adults who suffer from TMD have similar symptoms that often need to be treated by a doctor with special training in dealing with these issues. If you feel you’re suffering from a TMJ disorder, you may have any of the following symptoms:
- Ringing in the Ears or Ear Pain
- Clicking or Popping of the Jaw or locking open
- Eye Pain
- Grinding or clenching of teeth, sensitive teeth, broken teeth
TMJ induced headaches can be painful and long lasting, it is important to know the steps you can take to treat your pain. Over the counter tension headache medications will not always provide relief. There are certain jaw exercises that you can do regularly to help relieve pain and pressure.
Patients have also reported ringing in their ears along with ear pain prior to being diagnosed with a TMJ disorder. This pain could be dull or sharp depending on the severity. Ear pain may also be accompanied with a clicking sound from your jaw. Often what a patient feels as a problem with their ear can be properly diagnosed and treated as a TMJ problem.
Often times I treat patients who complain of a toothache that is actually a TMJ problem. I am referred patients very frequently from their primary care physician or ear, nose, and throat physician who rule out issues with a patient's ears or sinuses. These patients commonly have symptoms of a sinus infection or ear infection which is actually a TMJ issue.
Call us now for a free consultation if you notice any of the symptoms above or have questions regarding a potential TMJ issue at 973.256.0275.
10.17.16 How to Keep Your Teeth Healthy During the Month of October
Every October, much to all of us in the dental field's chagrin, stores fill their aisles with endless varieties of candy and kids across the country get ready for some sweet, sticky, chewy treats. For those of us concerned about dental health, this can be a scary thought. With a little knowledge you can prevent problems that can haunt you the entire year.
Who doesn't love all the sticky, gooey treats that seem to be so abundant this month? Fortunately, there are some delicious treats that are safer than others. In honor of protecting all those beautiful smiles, we’ve put together some easy tips to keep in mind this October.
1. Avoid sticky, chewy, or hard candies that can easily damage orthodontic work or dislodge fillings or caps. Some of the worst offenders are taffy, caramels, bubblegum, and jellybeans. Along with pulling out and breaking dental restorations, they will cause cavities more than other candies because thick, gooey candies stick to the teeth and keep the sugar in contact with the teeth longer.
2. Ahhh! There are some candies that need to be off-limits! Any soft, melt-in-your-mouth candies like chocolates and peanut butter cups are great alternatives to the sticky candies that keep the sugar in contact with the teeth causing cavities.
3. Beware! All candy is still full of sugar and thus cavity monsters. Be sure to brush and floss after each time consuming candy and consider a fluoride rinse in the evenings.
4. Halloween is only recognized once a year, but why not practice these tips all year long? By staying vigilant, you can keep those monsters hidden all year long.
As always, call us anytime with any questions--973-256-0275. Have a great Halloween!!
9.22.16 What to Do After An Extraction
There are lots of reasons that we might recommend a tooth extraction. Some dental patients suffer from tooth decay or infection, others need to remove teeth that are in the way of orthodontic treatment, and some patient need wisdom tooth removal for preventive purposes. While a tooth extraction can be a serious dental procedure, what you do after is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.
Care immediately following surgery:
- Keep pressure on the gauze pad that we placed over the surgical area by gently biting down. Dampen the gauze sponge with water if it begins to dry out. Try to maintain constant pressure in intervals of 45-60 minutes, repeating as often as needed, or until bleeding lessens. Change the gauze as needed. Generally twice is sufficient.
- Keep your head elevated and try to lower your activity level as much as possible. Take the day off from the gym--no weight lifting!
- Keep your mouth clean by brushing areas around the surgical site, but be sure to avoid sutures. Touching the wounded area in any fashion should be prevented. No rinsing for at least 24 hours to avoid breaking up or losing the clot resulting in a dry socket.
- Use ice packs to control swelling by placing them on facial areas near extraction twenty minutes on/twenty minutes off.
- Take all prescribed medications accordingly. If any itching or swelling occurs, contact the practice immediately, or go to the nearest emergency room.
- Try to eat softer foods, preferably high in protein, and on the opposite side.
- Keep your body hydrated by drinking plenty of fluids, but do not drink through a straw for the next 5-7 days.
- If you are a regular tobacco user refrain from smoking for the next 3-4 days as smoking increases your chances of getting a dry socket as well as an infection.
After your tooth has been extracted, healing will take some time. Within 3 to 14 days, your sutures should fall out or dissolve. For sutures that are non-resorbable, we will schedule a follow-up appointment to remove the stitches for you. Your tooth’s empty socket will gradually fill in with bone over time and smooth over with adjacent tissues.
Possible complications after a tooth extraction
Bleeding – Slight bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is fairly common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your slight bleeding does not reduce after 48 hours, please call the practice or call immediately if there is copious bleeding.
Bone sequestra (dead tooth fragments) – Some patients have small sharp tooth fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little painful until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.
Dry socket – In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and ousted before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket. Dry socket is not an infection but does require a visit to our office. If you think you may be suffering from dry socket, please contact the practice immediately.
Lightheadedness - Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.
Numbness – Many patients report still feeling numb hours after their tooth extraction procedure. An extended lack of feeling around the mouth is normal and can last 10-12 hours after surgery.
Swelling – Swelling should subside almost entirely within 7 days after surgery. Immediately following your tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face. As always call immediately with any concerns.
Trismus (difficulty opening and closing mouth) – If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain sore 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.
We are always available to answer any questions following any procedure. When not in the office, my cell phone number is on the office answering machine as I am always available for my patients.
8.1.16 Choosing the Right Toothpaste
The trip down the toothpaste aisle isn’t as simple as it used to be yeas ago. There used to be just a handful of choices – gel or paste – peppermint or spearmint. Nowadays, the same aisle is filled with a confusing lineup of different formulas. It can be a daunting task to find the right type of toothpaste for your particular needs or the needs of your family.
Toothpaste companies are showcasing their new formulas - some helpful for minor dental issues, while others only leave us with empty promises. Below I have put together a helpful guide to help make your next trip down the toothpaste aisle a little easier.
Fluoride is the primary ingredient that most all oral health professionals agree is great for helping maintain a healthy, beautiful smile – at any age. Fluoride helps in removing plaque; the main cause of gum disease and tooth decay. You will also find that fluoride is great for strengthening tooth enamel thereby preventing decay. Most all ADA-Accepted toothpastes contain fluoride. (A list of all ADA-Accredits toothpastes can be found at: http://www.ada.org/en/science-research/ada-seal-of-acceptance/ada-seal-products)
Bacteria, as well as certain foods and beverages, contain acid – a huge enemy to our teeth’s enamel. There are toothpastes on the market that claim to protect against acid erosion by “building” enamel. The bad news is – no toothpaste can rebuild lost enamel. The good news – you can protect your teeth from the acid that eats away at the enamel and it's this acid that causes the holes in teeth that is decay. If you are already using a toothpaste that contains fluoride, you are more than likely preventing enamel loss. It’s also important to reduce the amount of acidic food and beverages you consume – stay away from too many sports drinks, sodas and fruit.
Tartar Control Toothpastes
The main thing to know about tartar control formulas is that while they are effective at preventing tartar, they can’t reduce the tartar build-up that is already on your teeth. Professional tooth cleaning is the best way to remove existing tartar.
It is also important to note that some tartar control toothpastes have ingredients that can irritate your gums. If you have sensitive gums, you may have to weigh the discomfort you have while brushing your teeth with the benefits of the tartar control formula.
Toothpastes for Sensitive Teeth
Toothpastes that help with sensitivity have an ingredient in them that “block” the parts of your mouth that connect your teeth to underlying nerves. These toothpastes can be helpful for mild or moderate tooth sensitivity. Give the toothpaste a few weeks of use to notice the improvements.
Note: If your tooth pain is caused by gum disease or a cavity, this type of toothpaste will not be helpful.
Teeth Whitening Toothpastes
We are sorry to break it to you, but these types of toothpastes are over-hyped and most likely will disappoint you. If you are looking to just remove surface stains, teeth-whitening toothpaste may help, but as the American Dental Association has stated, no toothpaste has been proven to change the color of teeth. There also are no standardization regarding shade of teeth so a claim of four shades whiter, eight shades whiter, ten shades whiter have no real significance because it is usually a made up shading system by the manufacturer.
To effectively lighten the color of your teeth, it is important for you to talk with your dentist. We can perform a professional, tooth whitening procedure in-office or even recommend a treatment you can use at home. Call us anytime with questions regarding the various types of tooth whitening procedures.
As always, call us anytime with any questions regarding toothpastes or anything mentioned here. 973-256-0275. Have a great rest of the summer!
6.13.16 Warning Signs of Impacted Wisdom Teeth
There are few dental problems as painful for patients as impacted wisdom teeth. Understanding the symptoms of impacted wisdom teeth can help you know when to seek dental care. It is also possible to detect potential problems with impacted wisdom teeth early through regular dental checkups and a panoramic x-ray. In many situations we might even recommend that patients to consider wisdom teeth removal early, even if they have not reported any problems.
Don't Wait For Pain Before You Get Checked Out
Once a patient starts having problems with wisdom teeth, there is a good chance the wisdom tooth has become infected. If a tooth is infected, there are an array of signs and symptoms that will alert you that something is not right--pain, swelling, or a bad taste in the mouth are common signs of infection. If you experiencing any of these signs/symptoms then it is time to make an appointment to come in and see Dr. Ruggiero and his staff.
Three warning signs of impacted wisdom teeth are:
2. Swelling, Tender, Red or Bleeding Gums
3. Swelling Around the Jaw
Secondary, additional symptoms may include:
• Bad taste in the mouth
• Unpleasant breath
• Swollen glands
• Ear ache
• Headaches of the Temporomandibular Joint (TMJ), the connection between the jaw and skull
Complications of Impacted Wisdom Teeth
When wisdom teeth are impacted they can lead to crowding in the mouth, which can cause problems to the other teeth. This crowding can cause gum infections in and around the impacted areas. There are varying degrees of impaction, some partially impacted teeth may have part of the crown showing, while others never penetrate the gum and are fully impacted. There are potential complications for both partially impacted and completely impacted teeth. Complications can begin as bleeding gums or mild pain but if left untreated, these symptoms can develop into such hazards as:
• Damage to Adjacent Teeth: Wisdom teeth can push on the second molars, yielding infection or the requirement of orthodontia due to crowding.
• Gum Disease and Tooth Decay: Wisdom teeth are prone to infection and decay due to this area of the mouth being difficult to clean; this causes food and bacteria to become trapped between the teeth and gums.
• Development of Cysts: Wisdom teeth grow in a sac located within the jaw and when filled with fluid can develop an uncomfortable cyst that can damage nerves or become potentially more serious.
Unfortunately neglecting the issues you might be having with your wisdom teeth may lead to more serious complications. As soon as you begin experiencing any of the warning signs outlined above, it is important to schedule an appointment with Dr. Ruggiero and address the issue head on--or be proactive and call for a consultation today.
5.9.16 Lead in Our Water
One topic that has had the media and our patients abuzz has been the issues with lead in the water in Flint and, more recently, Newark. Flint, Michigan has made huge headlines over the past several months because of the water crisis happening there. About two years ago, the state decided to save money—during a financial state of emergency in Flint—by switching the water supply from Lake Huron (which they were paying the city of Detroit for), to the Flint River. This water source that runs through the town is well known to be filthy. The switch was supposed to be temporary.
But after the switch, residents started noticing that the water looked brown and dirty. It turns out the state’s Department of Environmental Quality wasn’t treating the Flint River water—which is high in harmful iron—with an anti-corrosive agent. This eroded the iron water mains. To make matters worse, about half of the water lines to Flint homes are made of lead. So because the water was corrosive, lead began seeping into the water supply, in addition to the iron.
When that happens, and residents (including young children) drink the contaminated lead water, it causes physical and neurological conditions that can last generations. Lead in water is highly toxic and dangerous.
Lead’s Harmful Effects
Lead is a toxic metal. Its use (such as lead paint in homes) has resulted in extensive environmental contamination, human exposure and substantial public health problems in many parts of the world—including the United States.
Lead in the body is detrimental on many levels. Once it enters the body, it gets into the brain, kidneys, liver and bones. It’s stored in the teeth and bones where it builds up over time. Lead stored in the bones may be reactivated into the blood stream during pregnancy, thus exposing the fetus.
Lead’s effects are nothing short of detrimental, especially for children:
- High levels of exposure. Lead attacks the brain and central nervous system, which can cause coma, convulsions and even death. Children who survive severe lead poisoning may be left with severe developmental delays and behavioral issues.
- Lower levels of exposure. Lead produces a vast amount of injury across multiple body systems. Particularly, it affects children’s brain development. This can result in a reduced intelligence quotient (IQ), behavioral challenges such as decreased attention span, increased antisocial behavior and lower educational achievement.
- Other conditions. Lead exposure also causes health conditions such as anemia, hypertension and adverse effects on reproductive organs. The neurological and behavioral results of lead are believed to be irreversible. There is no known safe amount of lead that can be in the body.
The most important thing you can do is educate yourself and check with your town water department as tests are done throughout the year and are available to the public. Contact your doctor if there is a concern.
5.5.15 Does My Emotional Health Affect My Teeth?
Stress can be harmful to us in many ways. In addition to taking a toll on emotional well being, it can impact physical health by increasing the risk of heart attack, stroke, and heart disease, affect sleep and memory, cause headaches, and worsen depression. Not only that, but it can impact the health of your smile!! Here’s what you need to know:
- Bruxism (teeth grinding): High levels of stress can lead you to grind your teeth at night or clench your jaw. If you think you might be doing this, talk to us about getting a night guard to protect your teeth. Prolonged teeth grinding can wear down your enamel, cause tooth decay or sensitivity, cause tension headaches, and may even do permanent damage to the jaw.
- Periodontal disease: Long-term stress can weaken your immune system. When the immune system is weak, your body has a harder time fighting off bacteria, which makes you more susceptible to infections like gum disease. Scientists have found a direct link between gum disease and heart disease. All the more reason--get your teeth cleaned twice a year!!
- Canker sores: Although the cause of canker sores is not known for sure, one potential trigger may be stress. Canker sores are suspected to have autoimmune causes and stress can worsen autoimmune diseases.
If you’re stressed, it’s extra important to take care of yourself, even if it’s easier to do the opposite. Be vigilant about brushing, flossing, eating healthy foods, and drinking plenty of water, and you can minimize the negative impacts of stress on your teeth and gums. As always, call us anytime with any questions at 973-2567-0275.
4.25.16 How Important is it to Be Checked for Oral Cancer?
In the past, oral cancer was thought to mainly affect older men with a lifetime of tobacco use. And it’s true that oral cancer is twice as common in men as in women, and lifestyle choices play a role. However, there has been a surprising rise in cases of oral cancer in younger people--and the vast majority of cases are symptom free. Here’s what to know:
- Why should young people get screened?Since oral cancer is generally more common in older people, young people are not screened as frequently. However, oral cancer is becoming more and more common at younger ages, and early detection can significantly increase your chances of successful treatment. A screening only takes a few minutes and there’s no reason not to have it done during your annual dental exam. We check for oral cancer at every examination.
- Why is it becoming more common in young people? Researchers have found that since 1984, there has been a positive correlation between the increase of human papillomavirus (HPV) and oral cancer. In fact, each year 33,000 new cases of cancer are found in parts of the body where HPV is found too. HPV can also cause other types of cancer, most commonly cervical cancer in women. This can also cause oral and throat cancer.
- What can you do? In addition to getting screened every year, it is recommended that preteen and teenage boys and girls get the HPV vaccination to protect against HPV infection. Women over age 30 should also consider getting an HPV test done. Prevention of oral cancer begins with an examination. Call today for an evaluation.
2.18.16 February is also National Pet Dental Health Month!
We just added a guinea pig named Maggie to our family. Surprisingly guinea pigs have teeth that never stop growing and her diet has to include foods that need to be chewed vigorously to wear down her teeth and prevent malocclusion. Also giving any pet "human" food is usually not recommended because of high sugar content and gastrointestinal incompatibilities. February is National Pet Dental Health Month and a good time to learn about your pet's dental health needs.
Your pet’s teeth should be checked at least once a year by your veterinarian for early signs of a problem and to keep your pet’s mouth healthy.
Have your pet’s teeth checked sooner if you observe any of the following problems:
- bad breath
- broken or loose teeth
- extra teeth or retained baby teeth
- teeth that are discolored or covered in tartar
- abnormal chewing, drooling, or dropping food from the mouth
- reduced appetite or refusal to eat
- pain in or around the mouth
- bleeding from the mouth
- swelling in the areas surrounding the mouth
Some pets become irritable when they have dental problems, and any changes in your pet’s behavior should prompt a visit to your veterinarian. Always be careful when evaluating your pet’s mouth, because a painful animal may bite.
Periodontal disease is the most common dental condition in dogs and cats – by the time your pet is 3 years old, he or she will very likely have some early evidence of periodontal disease, which will worsen as your pet grows older if effective preventive measures aren’t taken. Early detection and treatment are critical, because advanced periodontal disease can cause severe problems and pain for your pet. Periodontal disease doesn’t just affect your pet’s mouth. Other health problems found in association with periodontal disease include kidney, liver, and heart muscle changes.
Just like in humans, periodontal disease starts with plaque on the teeth that hardens into tartar. Tartar above the gumline can often easily be seen and removed, but plaque and tartar below the gumline is damaging and sets the stage for infection and damage to the jawbone and the tissues that connect the tooth to the jaw bone. Periodontal disease is graded on a scale of 0 (normal) to 4 (severe) and if untreated will lead to tooth mobility and loss.
The treatment of periodontal disease involves a thorough dental cleaning and x-rays may be needed to determine the severity of the disease. Your veterinarian or a board-certified veterinary dentist will make recommendations based on your pet’s overall health and the health of your pet’s teeth, and provide you with options to consider.
2.4.16 February is Children's Dental Health Month
Did you know February is National Children’s Dental Health Month? This month is dedicated to educating kids and parents about the benefits of great oral health. According to the CDC, cavities are the most common chronic disease among kids aged 6-19. In fact, a kid between the ages of 14-17 is 4x more likely to have cavities than asthma! With all that in mind, here are 5 things parents and kids can do:
- Use fluoride: If your child is over age 2, make sure their toothpaste contains fluoride. Also, check to see if your tap water has fluoride in it. If not, talk to us about fluoride supplements. Most public water in New Jersey is not fluoridated.
- Dental sealants: Talk to us about dental sealants. These are thin plastic coatings applied to the surface of the teeth, which acts as a barrier to help prevent cavities.
- Follow the “2x2” rule: Make sure your child is brushing their teeth for a full two minutes twice a day. It may help to make a brushing chart and use a timer.
- Eat right: Explain to your child how sugary and acidic foods can cause cavities and weaken tooth enamel. Educating children about how foods impact their health will give them the knowledge they need to make better food choices.
- Visit the dentist: Your child should have their first dentist visit by their first birthday. After that, they should continue to see the dentist at least once every year.
Remember--call us anytime at 973-256-0275 with any questions or concerns.
1.11.16 Gum Is Linked To Headaches in Children
A gum-chewing habit can result in chronic headaches, according to a study published recently in Pediatric Neurology. Researchers in Israel studied 30 young children and teens who were suffering from chronic migraines or tension headaches — and who also chewed gum from 1-6 hours per day. When they stopped chewing gum for one month, 19 reported that their headaches went away entirely while 7 said their headaches were less frequent and intense. To test the findings, 26 were asked to go back to gum-chewing; every one of them found that their headaches returned within days. Now that’s something to chew on! It is a long known issue that such "parafunctional" habits can and do cause tension headaches and issues with the TMJ joint in adults, now we have conclusive evidence of this in kids too. Sugar free gum can prevent cavities but like the old saying says--everything in moderation!
12.17.15 Which Toothpaste Should I Use?
This is a question we hear all the time and there isn't a simple answer.
Toothpastes come in many forms and boast different flavors, benefits, and endorsements. All are designed to remove surface bacteria and prevent the buildup of plaque that can cause tooth decay. With so many choices, we know that selecting the right toothpaste can be intimidating. After all, some benefits are welcome bonuses, while others are absolutely essential. So how can you know which toothpaste is best for you?
ADA Seal of Approval
While all toothpastes must first be approved by the Food and Drug Administration for sale to consumers, the American Dental Association puts these products through further rigorous tests for safety and effectiveness. Toothpaste that boasts the ADA Seal of Approval can be trusted to do exactly what it claims. These pastes have the correct amount of abrasives and detergents to clean the teeth properly while not destroying tooth structure.
Fluoride is an essential ingredient in a daily toothpaste. It helps to protect the tooth from decay by removing plaque and strengthening the enamel. Although fluoride is found in many public water supplies, many people are deficient in it due to the consumption of bottled water instead of tap water. All toothpastes with the ADA Seal of Approval contain fluoride in the appropriate amounts.
If a toothpaste meets the ADA’s standards and contains fluoride, the next step is to clear it with your dentist. This is especially true if you decide to use a whitening toothpaste, which often contains abrasives to remove surface stains. Though abrasives are an effective aid in tooth whitening, they may not be recommended if you have weak tooth enamel.
In certain situations, I may suggest or prescribe specialty toothpaste, depending on your oral health needs. For example, patients who are prone to tooth decay and cavities despite frequent brushing and flossing may benefit from prescription-strength fluoridated toothpaste to help prevent the weakening of tooth enamel. Others who suffer from tooth sensitivity may benefit from the use of desensitizing toothpaste. Feel free to speak to me if you think a specialty toothpaste could be right for you by scheduling an appointment.
You may notice that I did not list any brand names or specifics. The most important thing is to find a toothpaste that you like the taste and mouth feel of so you will brush the right amount of time and the right way. You will be surprised how quickly you brush if the toothpaste tastes bad or froths up too much (or not enough!). Just make sure the ADA seal is on the package and pick any that you like!
11.30.15 Healthy Eating for the Holidays--Is It Possible?!?
It seems like cookies, pies, and sweets are everywhere you turn this season. While indulging now and then is all part of the holiday fun, it’s important to avoid overloading on sugar.
Be conscious about what you put on your plate.Load up with healthy options first and then put a few sweets on the side. Only put on your plate what you feel comfortable eating and don’t go back for seconds. Sounds easy but it takes some willpower.
Keep healthy options available. Make fresh fruits or veggies as accessible as the cookie jar. Often we gorge on sugary foods simply because they’re available during the holidays. Instead, stock up on healthy alternatives. Watch the documentary Fed Up to see just how addictive sugar can be--literally! My son came home from school talking about what he learned watching it and what I saw was shocking.
Bring better choices. At holiday parties, bring a healthy dessert instead of adding to the pile of sugary sweets. Try dark chocolate-covered strawberries, homemade pumpkin pie, or fruit tarts. At least you will have something to eat!
Take a walk after meals and before dessert. It typically takes 20 minutes for your brain to process that your stomach is full. If you take a walk after dinner, by the time you get back you may realize how full you are and eat less dessert. As an added bonus, walking has also been shown to increase metabolism.
10.20.15 Halloween Hygiene Tips
By following these tips below, parents can help prevent tooth decay for their trick or treaters while teaching them good oral care habits:
1. Be Selective. All Halloween candy is not created equal. A good dental hygiene tip is to encourage kids to eat candy that melts fast and can be eaten quickly. Try to avoid gooey, sticky sweets (like caramels) that can linger on in the mouth and on the teeth. This will allow the bacteria in the mouth to produce more acid which will cause cavities. Remind kids after eating any sugary candy to brush their teeth or at the very least rinse their mouths out with water. This will lessen the amount of time the sugar stays in contact with the teeth. A really good idea might be to buy a new toothbrush that is Halloween related as a final “treat”.
2. Hide the excess candy. Do not just leave the Halloween candy around the house after the Halloween trick or treating is over. Store it in a secret place out of reach from kids and adults. A day or two is enough! Besides, the adults in the house will wind up eating it all--especially those "unwanted" candies.
3. Avoid grazing. If you maintain dental hygiene tip #2 this should not be an issue. The idea is not to just keep picking at the candy throughout the day. This reduces the time the sugars are in the mouth decreasing chance of tooth decay. A better idea is to hold back candy and use it as an after meal treat. Then have your child immediately brush and rinse to neutralize the sugar and acid production. Another option, if you cannot brush or rinse is to give them a sugar free xylitol gum. The gum will help increase salivary flow which will also help to neutralize the acids in the mouth.
4. Eat a Healthy Meal first. Have children not fill up on snacks and Halloween candy but fill up on a healthy nutritious meal first. This will give them less temptation to overdo their candy consumption. This is a good dental hygiene tip for all year and not just Halloween time.
So there you have it, a few easy tricks to allow you and your family to fully enjoy the Halloween time and avoid time in the dentist's chair. Candy is not necessarily the enemy, the enemy is not maintaining a diligent dental hygiene regimen. As always, make sure to visit us regularly for check ups and enjoy your Halloween!!
9.14.15. Back to School Tips for a Healthy Smile.
There are some steps children and parents can take to help ensure their teeth stay healthy and cavity-free:
- Brush before breakfast. There is little time to spare on most school mornings. Sometimes kids eat their breakfast on the way to school. It's not necessary to wait until after breakfast to brush. This will help ensure kids brush their teeth before heading off to school. The goal is to prevent the pH of the mouth from dropping to an unsafe zone since cavities form in an acidic environment. Studies show that if we brush before we eat, the mouth's pH will not dip low enough to form cavities.
- Don't micromanage. Some parents tell kids to hold off brushing until after they've fixed their child's hair. Allow children to brush their teeth while their hair is being done so no time is wasted and teeth are clean.
- Consider diet. School meals may contain processed and sugary foods. Parents who pack their child's lunch should focus on sending perishable items, such as fruits and vegetables, that will provide children with healthy alternatives. Sugar containing drinks are often an unrecognized source of decay.
- Don't overthink it. A little variety is nice, but there is no harm in giving kids the same lunch each day if it means it will be healthier. For example, cutting fruits and vegetables, and adding hummus and pita bread is healthy and convenient.
- Consider shelf life. Packaged foods that can sit on the shelf for a long period of time, such as crackers and pretzels, contain starch. Starch coats the teeth and can breed cavity-causing bacteria. Since kids may get these snacks at school, parents should avoid adding them to their pantry at home. Instead, opt for fresh fruits and vegetables.
- Choose water. Juice often contains more sugar than children should have in an entire day. This sugar can coat the teeth, promoting tooth decay. Sugar can also lead to an afternoon crash, which interferes with schoolwork. Instead of juice, give kids fruit and teach children to drink water and limit the amount of time the sugary drinks are in their mouth.
- Be safe. Kids participating in organized sports should wear mouth protection. This is particularly true if they play soccer, baseball and basketball. Children should also always wear a helmet when riding bicycles or scooters. Helmets should also be worn when roller skating or rollerblading.
- Seek help. Children who fall on their face should visit the nurse at school and the dentist as soon as possible. Sometimes issues can develop slowly. A minor problem could actually affect the root of a tooth. If a permanent tooth is knocked out it must be replaced within 30 minutes. Never scrub a tooth that has fallen out, even if it looks dirty. This could kill its root, making a tooth loss a possible outcome when oftentimes the tooth is salvageable.
- Don't expect pain. Cavities in children don't hurt until they become infected. So, some children with cavities may not complain about tooth pain.
- Be careful about braces. Dental care for those with braces is even more important. It can be tough to brush around braces and plaque can build up, leading to permanent damage. Teens often wear braces and hormonal changes that take place during adolescence can alter bacteria in the mouth.
The beginning of a new school year is usually a big transition, as lazy summer mornings are quickly replaced by mad dashes to the bus stop. These simple tips can help ease this transition for both the parents and the children. As always, call us anytime with any questions at 973-256-0275.
6.25.15. Summer Dental Emergency Guide.
Summer is here! When you think of summertime, what comes to mind? Sunshine and water? Watermelon and snow cones? Long days at the park? We think of all this, too, but we also think about dental emergencies. Most kids and teenagers are home from school and playing hard. Like many parents say, “It’s all fun and games until someone gets hurt!” We wish you a safe and fun summer, but accidents happen. In case a dental emergency occurs when you’re around, here are some basic guidelines for what to do:
Rinse the mouth with warm water. If you can, save the pieces from the tooth and rinse them thoroughly as well. To help prevent swelling, apply an ice pack to the swollen lip or gums around the tooth. Young children often do better with a popsicle if the traumatized tooth is not sensitive to the cold. If any area of the mouth is bleeding, apply pressure with wet, cool gauze or a washcloth until bleeding stops. An over-the-counter pain reliever such as acetaminophen or ibuprofen might be needed. Call us immediately! In the meantime, watch for swelling, fever, or changes in the color of the tooth.
Knocked Out Tooth
If the tooth is whole, hold it by the crown (not the root) and rinse it briefly with warm water. Don’t dry it. If possible, gently reinsert the tooth in the socket and hold it there by biting down on a piece of gauze or cloth. Permanent teeth have the highest chances of survival if they’re replaced in the mouth within 15-30 minutes. If the tooth can’t be put back in the socket, keep it in milk or in the floor of the mouth. Often times, if treated within a couple hours, the tooth could be saved. The most important thing is to call us immediately!
Soft Tissue Injury
The soft tissues in the mouth – gums, tongue, lips, and cheeks – tend to bleed quite heavily due to the tissues containing a great deal of blood flow. First, rinse the affected area, then apply pressure to control and stop the bleeding. Use a moistened washcloth or gauze for this. After bleeding stops, apply a cold pack to help reduce swelling and discourage residual bleeding. A bag of frozen peas wrapped in a dishtowel can do the trick. Use over-the-counter pain reliever and anti inflammatory medications as needed and as indicated on the medication’s directions. In the event of a serious injury with profuse bleeding or visibly traumatic damage, stay calm, apply pressure, and go to the nearest emergency room or urgent care center. Luckily, wounds in the mouth heal faster and with less scarring than wounds in other parts of the body.
Focus on Prevention
While being prepared for a dental emergency is important, sometimes the best preparation is prevention! Check indoor and outside play areas to determine whether they’re sufficiently childproofed, keeping potential falls in mind. Provide protective gear including mouth guards for contact sports, and have your children wear helmets while biking and skateboarding. Remind your kids (and yourself if needed) that your teeth aren’t tools for opening chip bags! Also remember your lips in the summer sun and apply a lip balm with UV protection. Be safe, have fun, and make emergency-free memories all summer long.
6/10/15. Some Sweet Information.
What do corn syrup, evaporated cane juice and agave nectar have in common? They are all names — aliases if you will — for sugar added to foods we eat every day. These include many foods you wouldn’t think of as being sugary: tomato sauce, bread and yogurt, for example.
Not only does eating or drinking too much sugar increase the chance of losing permanent teeth through decay and gum disease; it can also lead to “metabolic syndrome” — a cluster of serious risk factors for heart disease, diabetes and stroke. One definition of metabolic syndrome states that a person must have at least three of the following: high blood pressure, a high blood sugar level, a high triglyceride level (a type of fat in the blood), low HDL (“good”) cholesterol, or excess body fat around the waist. According to the National Institutes of Health, your risk for heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn’t have metabolic syndrome.
The American Heart Association says Americans consume about 22 teaspoons of sugar per day, when the maximum should be 9 teaspoons for adult men (about the amount in a can of soda), 6 for adult women, and 4 for children. These limits apply only to added sugar — not what occurs naturally in fruits, vegetables and milk. But limiting added sugar is no easy task, given how many foods contain it and the lengths to which the food industry goes to disguise it. That’s why I’ve compiled this list of sugar’s “other” names. Study it, and let the buyer beware!
Sugar’s Many Aliases:
Brown rice syrup
Cane juice crystals
Evaporated cane juice
High-fructose corn syrup
5/14/15. Get Ready for Wedding Season.
Now that wedding season is fast approaching, it’s time to be prepared for cameras and pictures at every turn. Is your smile up to the task? Here are some tips to get a picture-perfect smile for every occasion in the season.
Step 1: Brighten your pearly whites. This part’s easy—we have quick, one-hour teeth whitening available at our office. Toss those white strips. Now there is a better way. We were one of the first offices to offer ten minute whitening with Zoom Quick Pro whitening--4 shades whiter in 30 minutes for only $99 this summer (reg. $129). There are other ways to professionally whiten your teeth, but none that we've seen as quick and easy (and inexpensive!)
Step 2: Choose flattering makeup colors. The right lipstick can make teeth instantly appear whiter. Bright red, cherry red, rosy pink, and bright berry colors are your best bet. Avoid lipsticks with blue undertones since they can bring out yellow in your teeth. Using bronzer can also help make teeth appear brighter.
Step 3: Strike a pose. First, relax your face. Then, smile gently, maintain good posture, put your head back and your drop your chin down slightly. It also helps to turn your head at a slight angle to the camera.
Step 4: Wipe stains away. If you’ve been drinking red wine, gently wipe away wine stains on your teeth and lips with a damp napkin before picture time.
Step 5: Practice. There’s no shame in practicing your smile in the mirror to feel more confident when cameras come out. Try breaking into a smile effortlessly to make it look natural. Also note what angles work best for you.
Don’t forget, a healthy smile is a beautiful smile! Make sure to schedule regular visits to keep yours in the best shape. Call us today to schedule your cleaning or a free whitening consultation at 973.256.0275.
4/22/15. April is Oral Cancer Awareness Month.
Oral cancer is a form of cancer that most times is easily diagnosable but unfortunately is diagnosed at its later stages. From now until Memorial Day, we at Woodland Park Dental are providing free oral cancer screenings to all who would like to come by--just call us at 973.256.0275 to schedule an appointment. Here are some facts:
What is oral cancer?
Mouth cancer has the same meaning as oral cancer - it is a cancer that occurs in any part of the mouth; on the tongue's surface, in the lips, inside the cheek, in the gums, in the roof and floor of the mouth, in the tonsils, and also the salivary glands. It can show up as a red spot, white spot or an ulcer that doesn't go away after 7-10 days. If any of these conditions persist, it needs to be seen by a dentist immediately because in the early stages oral cancer is often symptom free. Oral cancer is also often very treatable in the early stages. If you have been putting off a visit to our Woodland Park office, now is an excellent time to schedule one. Regular visits can be the first line of defense against oral cancer, by identifying early warning signs of the disease, or helping you with preventive care tips to lower your chances of developing it.
Oral Cancer Rates in America
Nearly 40,000 people in the U.S. will be diagnosed with oral cancer this year, and more than 8,000 die every year from this disease. It is a devastating illness: most people who are diagnosed with it do not live more than five years beyond their diagnosis. Oral cancer has a higher death rate than many other common cancers, including cervical cancer, testicular cancer, Hodgkin’s lymphoma, and thyroid or skin cancers. The high death rate results from the fact that most oral cancers go undiagnosed until the disease is well advanced and has spread to another part of the body—most often, the lymph nodes in the neck.
What causes oral cancer?
While there is no way to predict exactly which individuals will get oral cancer, there are some potential causes you should know about—because in some cases, you can minimize these risk factors.
- Age (most patients diagnosed with oral cancer are over the age of 40)
- Tobacco use, either from cigarettes or smokeless chewing tobacco
- Excessive alcohol consumption (especially in combination with tobacco use)
- Persistent viral infections, such as HPV16
- A diet low in fruits and vegetables
In addition, oral cancer tends to occur at a rate six times greater in men than in women, and more often for African Americans than other ethnic groups. No genetic links have been identified to explain the higher incidence in these populations, so lifestyle choices remain the likeliest cause.
Oral Cancer Treatments
Once a diagnosis has been made, treatment of oral cancer usually involves a multi-disciplinary team that includes surgeons, oncologists, dentists, nutritionists, and rehabilitation and restorative specialists. Our team will decide on the best approach for each patient, depending on the risk factors and how far the cancer has progressed. The strategy will be different in every case. Some of the most common methods include chemotherapy, radiation, and potential surgery.
Finding out you have cancer can be devastating news. If you are concerned that you might be at risk for developing oral cancer, talk to us about screenings and other things you can do to reduce your risk. Call us today for a free oral cancer screening at 973.256.0275.
3/21/15. Straight Teeth in Just Months--Not Years!!
You may have seen the latest news about orthodontics on TV. Its called Invisalign, commonly called clear braces. Now you can have straight teeth in an average of 9-15 months instead of the two to four years in traditional braces. The best part with Invisalign is that there are no metal wires or brackets! Your teeth are straightened with a nearly invisible plastic retainer-like tray that is removed for eating and brushing. Most people will not notice you even have braces! Not sure if Invisalign is for you? Call for a free consultation today. 973.256.0275
2/4/15. The Truth About George.
So, George Washington had wooden teeth, right? Wrong!! In honor of our nation's first President, let's clear up this myth once and for all!
We were all brought up believing this myth. Actually, George Washington's first dentist, Charles Wilson Peale, wasn't a dentist at all. The reason: there were no dental schools at the time. Dentists were largely artisans trained by other artisans similar to blacksmiths or glass makers. The first dentures made for GW were made out of soft lead, into which human cadaver teeth were set. Sounds like something you'd want in your own mouth, right?? These dentures weighed just over a quarter of a pound and the upper and lower dentures were connected by coiled springs. So, his mouth was under constant pressure to stay open. Understandably, he couldn't bear to keep them in his mouth.
Washington's second set of dentures were different. These false teeth were made from several small, thin sheets of gold foil riveted together in the front and the back portion was made from carved ivory. It too had human cadaver teeth and both the upper and the lower were connected with springs. Both sets of false teeth had our friend GW looking like he had no teeth in his mouth. When he had his portrait painted as President, the artist stuffed cotton in his mouth to puff his cheeks out. Sadly this gave GW the benign, grandmotherly look we are all familiar with today--the one on the dollar bill.
1/28/15. Are you prepared for a dental emergency?
Thousands of dental emergencies—from injuries to a painful, abscessed tooth—take place every day. Would you know what to do if your child broke a tooth or had a tooth knocked out while playing outdoors? What if you had a bad toothache in the middle of the night and couldn’t get to the dentist until the next day? Knowing what to do can lessen the pain and save a tooth that might otherwise be lost.
Keep our dental office phone number and my emergency number (my cell phone number--201-819-5163) with other emergency numbers, such as your family doctor, and fire and police departments. Some families post these numbers on the refrigerator or inside a kitchen cabinet door near the phone. Call me immediately for instructions on how to handle a dental emergency.
Toothache: Rinse the mouth with warm water to clean it out. Gently use dental floss or an interdental cleaner to remove any food or other debris that may be caught between the teeth. Never put aspirin or any other painkiller against the gums near the aching tooth. This could burn gum tissue. If the toothache persists, try to come in to the office for an evaluation. Don’t rely on painkillers. They may temporarily relieve pain but we should evaluate the condition as soon as possible.
Knocked-out (avulsed) tooth: Try to find the tooth! This may not be as easy as you think if the injury took place on a playground, basketball court or while skateboarding, so try to stay calm. Hold the tooth by the crown and rinse the root in water if the tooth is dirty. Don’t scrub it or remove any attached tissue fragments. If it’s possible, gently insert and hold the tooth in its socket while you head to the dentist. If that’s not possible, put the tooth in a cup of milk and bring it to the office. Time is critical for successful reimplantation, so try to get to your dentist immediately.
Broken tooth: Rinse your mouth with warm water to clean the area. Use cold compresses on the outside of the cheek to help reduce the swelling. Call immediately.
Tongue or lip bites or wounds: Clean the area gently with a clean cloth and apply cold compresses to reduce any swelling. If the bleeding can’t be controlled, go to a hospital emergency room or clinic. You may able to reduce bleeding from the tongue by pulling it forward and using gauze to put pressure on the wound.
Objects caught between teeth: Try to gently remove the object with dental floss. Never use a sharp instrument to remove any object that is stuck between your teeth. If you can’t dislodge the object with floss, contact me immediately.
As you can see, one option (and the first thing I recommend) is to call immediately and we can walk through the symptoms and figure out the best way to deal with the issue. Remember, February is Dental Health Month--don't wait for a problem!
12/17/14. Have You Gotten the Most from Your Benefits This Year?
Now that December is here, it won’t be long until we’re taking down our calendars for 2014 and replacing them with ones for 2015. For most, the focus of the month is primarily on gift giving and holiday preparations, but there’s something else you should add to your year-end checklist: one last checkup with your dentist. Why should you include a dental appointment in your December acitivites? There are a few reasons.
Your insurance company allots a yearly maximum to help you pay for certain kinds of services and procedures. Unfortunately, that money doesn’t rollover from one year to the next. Any amount you don’t use, you will lose at the end of the year. You would be surprised how many people whose benefits are wasted at the end of the year when they have treatment diagnosed and needing to be completed.
Your deductible will be renewed every year, too. Before your insurance provider will start covering your care, you have to meet your deductible. In many cases, this amount is around $50. If you've met your deductible for 2014, this is an instant savings over treatment next year.
Additionally, you may find that your premiums and co-pays from one year to another are different--as employers try to cut costs that translates to decreases in benefits and increased costs to you in copays and ineligible services. But without knowing what they’ll be for 2015, it’s a good idea to take advantage of what you already have before it changes. Also, most insurance plans increase their fees yearly in the beginning of the year so treatment before the end of the year can result in lower fees for the same treatment.
Another New Year is almost upon us, but there may still be time to schedule an appointment. Call today to see about scheduling an appointment. Happy Holidays from all of us at Woodland Park Dental--remember we are always just a phone call away.
11/19/14. Holiday Teeth Whitening Advice
There are many reasons to smile this time of year. We have beautiful decorations, holiday gatherings with family and friends, delicious meals, savory desserts, and the joy of gift giving. But what will your family and friends see when you smile this holiday season? Over time, our teeth can discolor and stain because of foods and beverages like coffee, tea, and sodas. Your teeth can also yellow and stain from tobacco and alcohol use. However, they don’t have to stay that way. If you want your family and friends to see the dazzling white smile you had, make an appointment for professional teeth whitening today. You could brighten your smile this holiday season in just a half hour.
What About Teeth Whitening Toothpaste?
You may have already tried switching to a teeth whitening toothpaste. But whitening toothpaste is the least effective whitening option. Whitening toothpastes are made with mild abrasives that can only polish away shallow surface stains. They don’t contain the bleaching agents needed to truly alter the color of the enamel. It’s best to reserve whitening toothpaste to care for your teeth after you have used a more effective teeth whitening treatment.
Does Over-the-Counter Teeth Whitening Really Work?
These products may include whitening kits, whitening gels, whitening strips, or whitening rinses. They are widely available and they make a lot of promises. Yet, it can take several weeks of daily use to get any significant results with these products. In the meantime you’ll have to avoid any coffee, tea, soda, or wine until you’re finished with the treatment. Additionally, any misstep in their application could result in irritation or infection in your teeth or gums. The time, inconvenience, and risk of misapplication make these products difficult to recommend.
Professional Teeth Whitening for the Holidays
The easiest and most reliable choice is professional teeth whitening. We offer a one visit treatment or an easy-to-use take-home option. We use powerful bleaching agents that can whiten your teeth several shades in just one-hour. But, unlike the over-the-counter treatments, we can make sure that your teeth and gums are not irritated in the process. Sometimes, even professional bleaching agents may not be able to remove some forms of discoloration and deep staining so we can offer alternatives like dental bonding or veneers. Don’t make the mistake of using the wrong teeth whitening method. Get the brighter and whiter smile you deserve this holiday season with a professional whitening treatment.
I get a lot of questions from patients regarding jaw pain and headaches. Many of these symptoms are stress related. Let's face it--this is a stressful time for all of us and that stress can translate into muscular pain, stomach and gastrointestinal issues, skin problems, and other ways our body reacts to stress. For those of us whose stress rears its ugly head in muscle tension and spasms (I am one of you!), we can experience issues with neck and back pain, tension headaches, and jaw pain. Jaw pain is very common and is often accompanied by headaches, jaw clicking or popping, tooth breakage or sensitivity, and feelings of sinus or ear pain. Temporomandibular disorders (TMD) occur as a result of problems with the jaw, jaw joint, and surrounding facial muscles that control chewing and moving the jaw. These disorders are often incorrectly called TMJ, which stands for temporomandibular joint.
The cause of TMD is not clear, but dentists believe that symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself.
Injury to the jaw, temporomandibular joint, or muscles of the head and neck — such as from a heavy blow or whiplash — can cause TMD. Other possible causes include:
Grinding or clenching the teeth
Dislocation of the soft cushion or disc between the ball and socket
Presence of osteoarthritis or rheumatoid arthritis in the TMJ
Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
Limited ability to open the mouth very wide
Jaws that get “stuck” or “lock” in the open- or closed-mouth position
Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth (which may or may not be accompanied by pain) or chewing
A tired feeling in the face
Swelling on the side of the face
Most times, TMD can be treated with a mouth guard and relieves all or most of these symptoms. If you recognize these symptoms give us a call at 973-256-0275 for a free consultation.