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PlanAheadtoMakeYourSmiletheBestitcanbeforYourBigDay

The big day you've waited for all your life is just around the corner — your wedding day! And to make that day as special as possible you've been working on making yourself more attractive.

In all your preparations, don't forget your smile. There are many ways to make it shine, some requiring little time or effort. A professional dental cleaning and polishing, for example, can do wonders for brightening your smile. If you have above normal staining, you can also undergo professional whitening to remove stains and enhance your teeth's natural color.

Some problems, though, like chipped, slightly misaligned or heavily stained teeth may require more than a cleaning or whitening session. In these cases, you might consider covering these less attractive teeth with porcelain veneers to transform their appearance. As the name implies, veneers are a thin layer of tooth-colored, translucent porcelain custom designed for you and bonded permanently to the visible tooth.

While veneers can significantly change your smile, it can't fix every appearance problem. Some teeth require more extensive dental work, like a porcelain crown that completely covers a tooth, or dental implants to replace missing teeth. In more complex situations you may want to look at orthodontics to repair an unattractive bite, or plastic surgery to change the look of a gummy smile.

Keep in mind, though, many of such treatments take time: installing dental implants can take months and some orthodontic treatments, years. As soon as you can, you should discuss your smile appearance with your dentist and what can be done to enhance it in the time you have.

With the help of your dentist, orthodontist or other specialist, you can change your smile. And that, along with all your other preparations, will help make that once in a lifetime day even more special.

If you would like more information on undergoing a smile makeover, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Planning Your Wedding Day Smile.”

By Zev Maybruch, DDS
September 01, 2018
Category: Dental Procedures
Tags: anesthesia  
LocalAnesthesiaEliminatesPainCompletelyDuringDentalWork

Your teeth and gums are filled with nerves that make the mouth one of the most sensitive areas in the body. But thanks to local anesthesia, you won't feel a thing during your next dental procedure.

The word anesthesia means “without feeling or pain.” General anesthesia accomplishes this with drugs that place the patient in an unconscious state. It's reserved for major surgery where the patient will be closely monitored for vital signs while in that state.

The other alternative is local anesthesia, which numbs the area that needs treatment, while allowing the patient to remain conscious. The anesthetics used in this way are applied either topically (with a swab, adhesive patch or spray) or injected with a needle.

In dentistry, we use both applications. Topical anesthesia is occasionally used for sensitive patients before superficial teeth cleaning, but most often as an “opening act” to injected anesthesia: the topical application numbs the gums so you can't feel the prick of the needle used for the injectable anesthetic. By using both types, you won't feel any pain at all during your visit.

Because of possible side effects, we're careful about what procedures will involve the use of local anesthesia. Placing a sealant on the exterior of a tooth or reshaping enamel doesn't require it because we're not making contact with the more sensitive dentin layer beneath. We've also seen advances in anesthetic drugs in which we can now better control the length of time numbness will persist after the procedure.

All in all, though, local anesthesia will make your dental care more comfortable — both for you and for us. Knowing you're relaxed and comfortable allows us to work with ease so we can be unhurried and thorough. By keeping pain out of the equation, your dental care has a better chance for a successful outcome.

If you would like more information on managing discomfort during dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Local Anesthesia for Pain-Free Dentistry.”

By Zev Maybruch, DDS
August 22, 2018
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and your oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removing Wisdom Teeth.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Zev Maybruch, DDS
August 02, 2018
Category: Oral Health
Tags: oral hygiene   gum disease   pregnancy  
BabyYourTeethandGumsDuringPregnancy

For a healthy pregnancy, it helps to have healthy teeth and gums. In fact, the American College of Obstetricians and Gynecologists (ACOG) encourages its members to advise expectant moms to see their dentist. But maintaining oral health can be more challenging when you’re expecting. For one thing, hormonal changes make you more susceptible to periodontal (gum) disease, which has been linked to “systemic” (general body) health problems including preterm labor and low birth weight.

Periodontal (gum) disease results from the buildup of bacterial plaque on tooth surfaces in the absence of good oral hygiene. It typically starts as gingivitis — inflammation and redness around the gum margins and bleeding when brushing and flossing. If the infection progresses, it can attack the structures supporting the teeth (gums, ligaments, and bone) and may eventually result in tooth loss. And if the infection enters the bloodstream, it can pose health risks elsewhere in the body. Studies suggest that oral bacteria and their byproducts are able to cross the placenta and trigger an inflammatory response in the mother, which may in turn induce early labor.

TLC for Your Oral Environment

Brushing twice daily with fluoride toothpaste and flossing or using another interdental cleaner at least once daily is your first-line defense again bacteria buildup. Professional cleanings are also important to remove hardened plaque (calculus) that brushing and flossing may miss. And regular checkups can catch problems early to avoid or minimize adverse effects. Periodontal disease and tooth decay aren’t always painful or the pain may subside, so you won’t always know there’s a problem.

Dental emergencies such as cavities, root canals and tooth fractures should be treated promptly to address pain and infection, thereby reducing stress to the developing fetus. Of course, if you know you need a cavity filled or a root canal prior to becoming pregnant, that’s the optimal time to get treated!

If you would like more information about dental care during pregnancy, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “Pregnancy and Oral Health.”





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