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By Joshua H Kanner DDS PC Bryan D Pieroni DDS
December 03, 2021
Category: Oral Health
Tags: shingles  
ACaseofShinglesCouldImpactYourUpcomingDentalVisit

Most childhood sicknesses are highly treatable and quickly fade from memory afterward. But there's one viral infection that can reappear years later, albeit in a different form and this time it might not be as forgettable. It could even impact your dental care.

Varicella, more commonly known as chicken pox, is a viral infection that mainly affects children. Fortunately, the itchy blisters and other symptoms associated with it usually clear up on their own. But the virus itself, varicella zoster virus (VZV), can remain behind and become dormant.

Fast-forward a few decades, and the child once with chicken pox is now an adult, usually over 50. In 20-30% of former chicken pox patients, the virus reactivates as a new infection known commonly as shingles.

Shingles often begins with an itching, burning or numbing sensation on the skin that develops into a severe rash. Because of its effect on surface nerves, the rash often takes on a striped or belt-like pattern on the skin. A shingles outbreak can also cause fever, fatigue and pain, the latter of which in rare cases can be quite severe.

Shingles in its early stages is also highly contagious, transmitted easily through either physical contact with the skin lesions or through airborne secretions. This is especially troubling for certain groups: pregnant women, patients undergoing cancer or other serious disease treatment, or those with compromised immune systems. For them, shingles can pose a significant risk for complications.

Because of its easy transmission, and the danger it can pose to certain groups, dentists typically postpone treatment—even routine dental cleanings—for patients experiencing a shingles outbreak, especially a facial rash. Once their outbreak subsides, those procedures can be rescheduled.

If you develop what you think is shingles, you should seek medical attention as soon as possible. Certain prescribed antiviral medications can ease the symptoms and hasten recovery, but they're most effective if started within three days of the onset of the disease. There's also an effective vaccination for shingles recommended for people over 60 to help avoid the disease altogether.

One other thing! If you do develop shingles and have an upcoming dental appointment, let your dentist know. Better to reschedule your visit after you've recuperated than to put others' health at risk.

If you would like more information on shingles and 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 “Shingles, Herpes Zoster.”

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
November 23, 2021
Category: Dental Procedures
Tags: root canal  
GotQuestionsAboutRootCanalsWeHaveAnswers

You might have a few questions should you find out you need a root canal for a tooth infected with advanced decay. Most will be about what you should expect before, during and after a procedure.

But first, let's deal with a couple of your obvious concerns right upfront:

  1. No, contrary to your Uncle Bill, it won't be painful (if the infected tooth is throbbing, though, the procedure will relieve your pain);
  2. Yes, based on outcomes for millions of treated teeth over several decades, the odds are high the procedure will save your tooth.

As to other questions you might have, here's a basic 411 concerning your upcoming root canal procedure.

The "Why." Many consider tooth decay to be mainly a cavity forming in the outer enamel and dentin layers of a tooth. But tooth decay can destroy tooth structure as it advances through to the pulp, the heart of a tooth. The resulting infection will also spread into the root canals to eventually infect the roots and supporting bone. A root canal treatment removes the decay and stops the advancing infection in its tracks.

The "How." There are a number of variations on the procedure, but they all follow this basic process: After thoroughly numbing the tooth and surrounding tissues, we drill a hole into the tooth to access the pulp chamber and the root canals. We then remove all infected tissue through this access and disinfect the tooth's interior spaces. We then fill these spaces with a rubber-like filling to prevent future infection.

The "After." Once we've completed filling, we seal the access hole. Sometime later, we'll crown the tooth to provide further protection against infection and add support to the tooth. In the meantime, you may have a few days of discomfort, which is usually manageable with mild pain-killers like ibuprofen or acetaminophen.

A lot of root canals can be performed by a general dentist, but more complicated cases may require an endodontist. In either scenario, a root canal could give your infected tooth another chance at life that it wouldn't otherwise have.

If you would like more information on root canal therapy, 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 “Root Canal Treatment.”

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
November 13, 2021
Category: Oral Health
Tags: gum disease  
TroublingDataSaysSmokingMarijuanaCouldWorsenGumDisease

It seems with each new election cycle another U.S. state legalizes marijuana use. It remains a flashpoint issue that intersects politics, law and morality, but there's another aspect that should also be considered—the health ramifications of using marijuana.

From an oral health perspective, it doesn't look good. According to one study published in the Journal of Periodontology a few years ago, there may be a troubling connection between marijuana use and periodontal (gum) disease.

Gum disease is a common bacterial infection triggered by dental plaque, a thin biofilm on tooth surfaces. As the infection advances, the gum tissues become more inflamed and lose their attachment to teeth. This often results in widening gaps or "pockets" between the teeth and gums filled with infection. The deeper a periodontal pocket, the greater the concern for a tooth's health and survivability.

According to the study, researchers with Columbia University's College of Dental Medicine reviewed data collected from nearly 2,000 adults, a quarter of which used marijuana at least once a month. They found the marijuana users had about 30 individual pocket sites on average around their teeth with a depth of at least 4 millimeters. Non-users, by contrast, only averaged about 22 sites.

The users also had higher incidences of even deeper pockets in contrast to non-users. The former group averaged nearly 25 sites greater than 6 millimeters in depth; non-users, just over 19. Across the data, marijuana users appeared to fare worse with the effects of gum disease than those who didn't use.

As concerning as these findings appear, we can't say that marijuana use singlehandedly causes gum disease. The condition has several contributing risk factors: diet, genetics, and, most important of all, how well a person manages daily plaque removal, the main driver for gum disease, through brushing and flossing.

Still, the data so far seems to indicate using marijuana can make gum disease worse. Further studies will be needed to fully test this hypothesis. In the meantime, anyone using marijuana should consider the possible consequences to their oral health.

If you would like more information on marijuana and oral health, please contact us or schedule an appointment for a consultation.

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
November 03, 2021
Category: Dental Procedures
TheDisappearingToothGap-MichaelStrahanPullsanEpicAprilFoolsPrank

If you're a fan of former NFL player and current host of Good Morning America Michael Strahan, then you're well aware of his unique smile feature—a noticeable gap between his front teeth. So far, Strahan has nixed any dental work to correct the gap, often saying it was part of "who I am."

But if you follow him on Twitter, you may have been shocked by a video he posted on March 30th of him sitting in a dentist's chair. Calling it a "moment fifty years in the making," Strahan said, "Let's do it." After some brief video shots of a dental procedure, Strahan revealed a new gapless smile.

But some of his Twitter fans weren't buying it—given the timing, they sniffed an elaborate April Fool's Day ruse. It turns out their spider senses were on target: Strahan appeared once again after the video with his signature gap still intact, grinning over the reaction to his successful prank.

The uproar from his practical joke is all the more hilarious because Strahan has let it be known he's truly comfortable with his smile "imperfection." But it also took him awhile to reach that point of acceptance, a well-known struggle for many people. On the one hand, they want to fix their dental flaws and improve their smile. But then again, they're hesitant to part with the little "imperfections" that make them unique.

If that's you, here are some tips to help you better navigate what best to do about improving your smile.

See a cosmetic dentist. A cosmetic dentist is singularly focused on smile enhancement, and particularly in helping patients decide what changes they want or need. If you're looking for such a dentist, seek recommendations from friends and family who've changed their smiles in ways you find appealing.

Get a "smile analysis." Before considering specific cosmetic measures, it's best to first get the bigger picture through an examination called a "smile analysis." Besides identifying the defects in your smile, a cosmetic dentist will use the analysis to gauge the effect any proposed improvements may have on your overall facial appearance.

Embrace reality. A skilled cosmetic dentist will also evaluate your overall oral health and assess how any cosmetic procedures might impact it. This might change your expectations if it whittles down the list of enhancement possibilities, but it may help determine what you can do to get the best improved smile possible.

A great cosmetic dentist will work diligently with you to achieve a new smile that's uniquely you. Even if, like Michael Strahan, you decide to keep a trademark "imperfection," there may still be room for other enhancements that will change your appearance for the better.

If you would like more information about a "smile makeover," please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cosmetic Dentistry.”

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
October 24, 2021
Category: Dental Procedures
WhatYouCanDoToReduceGumProblemsWhileWearingBraces

Wearing braces can ultimately give you a healthier and more attractive smile. In the short-term, though, your gums in particular may be in for a rough ride.

While we're all susceptible to gum disease, braces wearers are more likely to encounter it. This stems from two related factors: the difficulty braces pose to oral hygiene; and the potential irritation of soft tissues by the braces themselves.

The main cause for any form of gum disease is dental plaque, a thin bacterial film that accumulates on teeth. Removing plaque through brushing and flossing greatly reduces the risk of any dental disease. But braces wires and brackets make it difficult to brush and floss—as a result, some plaque deposits may escape cleaning, which makes a gum infection more likely.

To exacerbate this, braces hardware can irritate the gums and cause swelling and tissue overgrowth, also known as hyperplasia. The one-two punch of ineffective hygiene with hyperplasia are why braces wearers have a higher incidence of gum problems compared to the general population.

To guard against this, patients with braces need to be extra vigilant about keeping their teeth and gums clean of plaque. It may be helpful in this regard to use specialized tools like interproximal brushes with narrower bristle heads that are easier to maneuver around braces.

And rather than using traditional flossing thread, orthodontic patients may find it easier and more effective to use pre-loaded flossing picks or an entirely different method called oral irrigation. The latter involves a handheld wand that directs a stream of pulsating water between teeth to loosen and flush away plaque.

It's also important for patients to see their dentist as soon as possible for any gum swelling, bleeding or pain. The dentist can determine if it relates to gum disease, hyperplasia or a combination of both, and recommend treatment. In extreme cases, it may be necessary to remove the braces until the gums heal, so catching and treating any gum problem early is a priority.

Regardless of the risk for gum disease, orthodontic treatment is still well worth the investment in your health and appearance. Practicing effective oral hygiene and keeping a watchful eye on your gums will help further lower that risk.

If you would like more information on oral care during orthodontic treatment, 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 “Gum Swelling During Orthodontics.”





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