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By Joshua H Kanner DDS PC Bryan D Pieroni DDS
April 01, 2020
Category: Oral Health
Tags: gum disease  
4SeriousHealthConditionsThatGumDiseaseMightMakeWorse

A disease happening in one part of your body doesn’t necessarily stay there. Even a localized infection could eventually affect your general health. Periodontal (gum) disease, a bacterial infection that damages gums, teeth and supporting bone, is a case in point.

There’s now growing evidence that gum disease shares links with some other serious systemic diseases. Here are 4 serious health conditions and how gum disease could affect them.

Diabetes. Gum disease could make managing diabetes more difficult—and vice-versa. Chronic inflammation occurs in both conditions, which can then aggravate the other. Diabetics must deal with higher than normal glucose levels, which can also feed oral bacteria and worsen existing gum disease. On the plus side, though, effectively managing both conditions can lessen each one’s health impact.

Heart disease. Gum disease can worsen an existing heart condition and increase the risk of stroke. Researchers have found evidence that chronic inflammation from gum disease could further damage already weakened blood vessels and increase blood clot risks. Treating gum disease aggressively, on the other hand, could lower blood pressure as much as 13 points.

Rheumatoid Arthritis. The increased inflammatory response that accompanies arthritis (and other diseases like lupus or inflammatory bowel disease) can contribute to a higher risk for gum disease. As with the other conditions previously mentioned, chronic inflammation from a gum infection can also aggravate arthritis symptoms. Treating any form of chronic inflammation can ease symptoms in both arthritis and gum disease.

Alzheimer’s disease. The links of Alzheimer’s disease to gum disease are in the numbers: a recent study found people over 70 who’ve had gum disease for ten or more years were 70% more likely to develop dementia than those with healthy gums. There is also evidence that individuals with both Alzheimer’s and gum disease tended to decline more rapidly than those without gum disease.

From the accumulating evidence, researchers now view gum disease as more than an oral problem—it could impact your total health. That’s why you should adopt a disease prevention strategy with daily brushing and flossing and regular dental visits (or whenever you notice puffy, reddened or bleeding gums). Stopping gum disease could provide you a health benefit well beyond preserving your teeth and gums.

If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation.

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
March 22, 2020
Category: Oral Health
Tags: topical fluoride  
TopicalFluorideisaSafeWaytoProtectYourChildsTeethfromDecay

We've known for decades that fluoride strengthens tooth enamel and lowers the risk for decay. And while adding it to toothpaste and drinking water are the more common ways for getting it into the body, an increasingly popular way—especially for children—is to apply fluoride directly to the teeth.

But is topical fluoride really worth the effort and expense? And, are there any side effects to treating teeth this way?

As to the first question, researchers have performed numerous studies measuring fluoride's effectiveness for preventing tooth decay. The Cochrane Oral Health Research Group recently reviewed studies on topical fluoride applications involving nearly 10,000 children and adolescents between the ages of 2 and 15. The combined average for all the studies showed a 28% reduction in decayed teeth for patients who received topical fluoride compared to those who didn't.

This was especially true for children at high risk for decay: directly applying fluoride gels, foams or varnishes to teeth reduces that risk substantially. But there are also side effects to this application. Fluoride in general has only one known safety concern, a condition known as fluorosis. Too much fluoride over time can cause heavy discoloration of the teeth. This does not affect the health of the teeth, but it can look unattractive and require cosmetic treatment to reduce its effect.

There's little to no risk for fluorosis with the controlled treatments offered by dentists; the fluoride solution remains on the teeth no more than a few minutes. But there is a possible side effect during treatment due to the relatively high dose of fluoride used. If the patient accidentally swallows some of the solution, the concentration of fluoride can cause stomach upset, vomiting or headaches.

Dentists minimize the chances for this by usually using the more difficult to swallow varnish form of topical fluoride on younger patients, and using trays or other barrier devices to isolate the fluoride solution from the rest of the mouth. Under professional supervision, it's rare for an accidental ingestion to occur.

The risks for these side effects are quite low, and the benefits of topical fluoride for reducing the chances for decay can more than outweigh them. Fluoride applications are one of many ways we can protect your child's current and future dental health.

If you would like more information on decay prevention techniques like topical fluoride, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride Gels Reduce Decay.”

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
March 12, 2020
Category: Oral Health
CustomMouthguardsArentJustforNFLSuperstars

If while watching a Seattle Seahawks game you thought you saw wide receiver D. K. Metcalf sucking on a “binky,” your eyes weren’t deceiving you. Well, sort of not—he’s actually been known to wear a mouth and lip guard shaped like a child’s pacifier.

Metcalf isn’t the only pro football player customizing this essential piece of safety equipment. Broncos running back Ronnie Hillman has been seen sporting “vampire fangs.” And Odell Beckham Jr., wide receiver with the Cleveland Browns, has a series of interchangeable guards with various designs and colors.

You may say, “That’s the NFL, so of course players have the money and fame to dress up their mouthguards with a little flair.” But custom mouthguards aren’t out of reach for the average athlete—in fact, it’s actually a sound idea. Not so much for expressing personality, but for the comfort and protective advantages that a custom mouthguard may have over retail varieties.

Usually made of high-resistant plastic, an athletic mouthguard absorbs blows to the face and mouth during hard contacts in sports like football, basketball and hockey. Mandated by many organized sports associations, mouthguards can prevent dental and facial injuries like chipped or knocked out teeth, gum abrasions or jaw fractures. There’s even some evidence they reduce the risk of concussion.

Many amateur players use what is known as a “boil and bite” mouthguard, available in retail sporting goods stores. They’re softened first, usually in hot water, and then placed in the mouth and clenched between the jaws to obtain a somewhat individualized fit.

Although they do provide some level of protection, a boil and bite mouthguard can’t match the accuracy of a custom mouthguard produced by a dentist based on impressions and measurements of an individual player’s mouth. As a result, custom mouthguards can be made thinner than many boil and bite guards, increasing their comfort while being worn. More importantly, their accurate fit enhances their protective capabilities.

As you might imagine, custom mouthguards are more expensive than their retail counterparts, and with younger athletes whose mouth structures are still growing, it may be necessary to upgrade a custom guard after a few seasons. Still, the cost of a custom mouthguard may be well worth the superior protection it provides for your own little star athlete. And although it may not necessarily look like a binky or vampire fangs, a custom mouthguard could make their playing experience safer and more comfortable.

If you would like more information about custom athletic mouthguards, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
March 02, 2020
Category: Oral Health
Tags: loose tooth  
ALooseToothisaSignofDeeperDentalTrouble

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

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

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

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

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

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

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

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

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

By Joshua H Kanner DDS PC Bryan D Pieroni DDS
February 21, 2020
Category: Dental Procedures
AdvancesinPorcelainVeneersImproveBothStrengthandAppearance

One of the best restorative options for slightly deformed, misaligned or stained teeth is a porcelain veneer. Composed of thin, laminated layers of dental material, the veneer is bonded to the outside of the tooth to transform both its shape and color to blend with other natural teeth.

Veneers are more than a technical process — they’re works of art produced by skilled artisans known as dental lab technicians. They use their skills to shape veneers into forms so life-like they can’t be distinguished from other teeth.

How technicians produce veneers depends on the material used. The mainstay for many years was feldspathic porcelain, a powdered material mixed with water to form a paste, which technicians use to build up layers on top of each other. After curing or “firing” in an oven, the finished veneer can mimic both the color variations and translucency of natural teeth.

Although still in use today, feldspathic porcelain does have limitations. It has a tendency to shrink during firing, and because it’s built up in layers it’s not as strong and shatter-resistant as a single composed piece. To address these weaknesses, a different type of veneer material reinforced with leucite came into use in the 1990s. Adding this mineral to the ceramic base, the core of the veneer could be formed into one piece by pressing the heated material into a mold. But while increasing its strength, early leucite veneers were thicker than traditional porcelain and only worked where extra space allowed for them.

This has led to the newest and most advanced form that uses a stronger type of glass ceramic called lithium disilicate. These easily fabricated veneers can be pressed down to a thickness of three tenths of a millimeter, much thinner than leucite veneers with twice the strength.  And like leucite, lithium disilicate can be milled to increase the accuracy of the fit. It’s also possible to add a layer of feldspathic porcelain to enhance their appearance.

The science — and artistry — of porcelain veneers has come a long way over the last three decades. With more durable, pliable materials, you can have veneers that with proper care could continue to provide you an attractive smile for decades to come.

If you would like more information on dental veneers, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers.”





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