As a Dentist, I have the privilege of designing not only new, healthy smiles but helping transform the lives of my patients on many levels. Over my 30 years in dentistry, there is nothing more fulfilling than to see the confidence and self-esteem my patients gain from having a well-invested cosmetic treatment. Every area of their lives is enhanced; from the quality of their relationships to the success of their careers; to the person they wake up to each morning as they glance at themselves in the mirror filled with pride and gratitude.

Karol has been a loyal patient in our practice for over 24 years. Several years after I recommended cosmetic treatment, Karol was ready to start her smile makeover. Now the fact that she had a high school reunion coming up certainly gave her even more incentive to make a decision!

Here’s what we did for Karol:

We performed a gum lift to enhance her smile and then added a combination of porcelain crowns and porcelain veneers. As you can see, there is a dramatic difference in her teeth before vs. after – but can you “feel” her newly found confidence? Just gorgeous! By the way, she had a blast at her reunion and came home smiling ear to ear.

Mouthguards

What is a mouthguard?  A mouthguard is a flexible appliance made out of plastic that is worn in athletic and recreational activities to protect teeth from trauma.

Why should I wear a mouthguard? To protect your mouth from injuries. The dental professional unanimously supports the use of mouthguards in a variety of sports activities. More than 200,000 injuries to the mouth and jaw occur each year.

Do mouthguards prevent injuries?  A mouthguard can prevent serious injuries such as concussions, cerebral hemorrhages, incidents of unconsciousness, jaw fractures and neck injuries by helping avoid situations where the lower jaw gets jammed into the upper jaw.

Mouthguards are effective in moving soft tissue in the oral cavity away from the teeth, preventing lacerations and bruising of the lips and checks, especially for those who wear orthodontic appliances.

In what sports should I wear a mouthguard?  Anytime there is a strong chance for contact with other participants or hard surfaces, it is advisable to wear a mouthguard.  Players who participate in basketball, softball, football, wrestling, soccer, lacrosse, rugby, in-line skating, martial arts as well as recreational sports such as skateboarding and bicycling should wear mouthguards while competing.

Why don’t kids wear mouthguards?  Parents are sometimes uninformed about the level of contact and potential for serious dental injuries involved with sports in which the child participates.  Some, though not all schools, reinforce the health advantage of mouthguards for their contact sports.  Cost may be another consideration, although mouthguards come in a variety of price ranges.

What are the different types of mouthguards?

Stock mouthguards: The lowest cost option is a stock item, which offers the least protection because the fit adjustment is limited.  It may interfere with speech and breathing because this mouthguard requires that the jaw be closed to hold it in place.  A stock mouthguard is not considered acceptable as a facial protective device.

Mouth-formed protectors:  These mouthguards come as a shell-liner and “boil-and-bite” product. The shell is lined with acrylic or rubber. When placed in an athlete’s mouth, the protector’s lining material molds to the teeth and is allowed to set.

Custom-made mouth protectors: The best choice is a mouthguard custom-made by the dentist.  It offers the best protection, fit and comfort level because it is made from a cast of your own teeth.

How should I care for a mouthguard?

• Clean your mouthguard by washing it with soap and warm (not hot) water
• Before storing, soat your mouthguard in mouthwash
• Keep your mouthguard in a well-ventilated plastic storage box when not in use.  Make sure the box has several holes so the mouth-guard will dry.
• Heat is bad for mouthguards, so don’t leave it in direct sunlight or in a closed automobile.
• Don’t bend your mouthguard when storing
• Don’t handle or wear someone else’s mouthguard
• Call the dentist who made the mouthguard if there are any problems

This information was complied by the Academy of General Dentistry

A number of factors increase the probability of developing periodontal disease including diabetes, smoking, poor oral hygiene, diet, and genetic makeup; and it is the primary cause of tooth loss in adults.

How are periodontal disease an diabetes related? It is estimated that 12 to 14 million people, or one-third of the population in the United States, have diabetes, but only one-half of these individuals are diagnosed.

Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal disease than those  who do not have diabetes.  Oral infections tend to be more severe in diabetic patients than non-diabetic patients.  And, diabetics who do not have good control over their blood sugar levels tend to have more oral health problems.  These infections occur more often after puberty and in aging patients.

What types of problems could I experience? Diabetics may experience diminished salivary flow and burning mouth or tongue.  Dry mouth (xerostomia) also may develop, causing an increased incidence of decay.  Gum recession has been found to occur more frequently and more extensively in moderate and poorly controlled diabetics patients because the bacterial biofilm (plaque) responds differently, creating more harmful proteins.  To prevent problems with bacterial infections in the mouth, the dentist may prescribe antibiotics, medicated mouth rinses, and more frequent cleanings.

How can you stay healthy? Make sure to take extra good care of your mouth and have dental infections treated immediately.  Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease.

Diet and exercise may be the most important changes that diabetics can make to improve their quality of life and their oral health. Diabetic patients should be sure both their medical and dental care providers are aware of their medical history and periodontal status.  To keep teeth and gums strong, diabetic patients should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis. These may have a direct correlation on your chances of developing periodontal disease.

What is the best time to receive dental care? If your blood sugar is not under control, talk with both your dentist and physician about receiving elective dental care.  Dental procedures should be as short and stress free as possible. Also make morning appointments because blood glucose levels tend to be under better control at this time of day.

If you have a scheduled appointment, eat and take your medications as directed. See your dentist on a regular basis, keep him or her informed of your health status, and keep your mouth in good health.

What are porcelain veneers? Porcelain veneers are ultra-thin shells of ceramic material, which are bonded to the front of teeth.  This procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth.  Porcelain veneers are placed to mask discolorations, to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth, resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options. 

Why a porcelain veneer?  Porcelain veneers are an excellent alternative to crowns in many situations. Because very little of the natural tooth structure is removed in the process, they provide a much more conservative approach (as compared to a full crown) to changing a tooth’s color, size, or shape.  Porcelain veneers can mask undesirable defects such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth.  Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.  

Generally veneers will last for many years, and the technique has shown remarkable longevity when properly performed.  Veneers may not be appropriate for patients who have strong chewing forces or for those who brux and grind their teeth. Full porcelain crowns will be stronger and have less of a tendency to fracture in this situation.  They may also not be suitable if closing the spaces between the teeth would mean creating larger than normal teeth, creating a “horse-like” result. Orthodontic movement of the teeth may reduce the spaces and give a more natural appearance.  If the teeth have large existing fillings, decay or large areas that have been fractured, porcelain crowns may be the treatment of choice.

What happens during the procedure?  Patients need at least three appointments for the entire procedure: diagnosis and treatment planning, preparation, and placement.

Diagnosis and treatment planning  It is critical that you take an active role in the smile design.  Spend time in the decision-making and planning of the smile. Understand the corrective limitations of the procedure.  Have more than one consultation, if necessary, to feel comfortable that we understand your objectives.  Often we will perform an additional diagnostic procedure where the veneers are created in wax so you can see exactly what they will look like before we get started. There is an additional charge for the “wax up” procedure that is normally done by the laboratory.

Preparation of teeth.  This appointment will take from one to two hours.  To prepare the teeth for the porcelain veneers, the teeth are lightly buffed or reduced to allow for the small added thickness of the veneer.  Usually about a half a millimeter of the tooth is removed, which may require a local anesthetic.  At this appointment a mold is taken of the teeth. This is then sent to the laboratory for the fabrications of the veneers.  This can take approximately  2 to 3 weeks.  If the teeth are too unsightly, or a bit sensitive,   temporary veneers will be fabricated and temporarily cemented to the newly prepared teeth.

Placement of veneers. This appointment will take about one or two hours. First, we will place the veneers in water or glycerine on the teeth to check their fit and get a sense of the shade or color.  While the veneers are resting on your teeth view the esthetic results, and pay particular attention to the color. At this point the color of the veneers can still be adjusted with the shade of the adhesive to be used. The color cannot be altered after veneers are placed. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam initiates the release of a catalyst to harden the adhesive.

How about maintenance?  For about a week or two, you may go through a period of adjustment as you get used to your “new” teeth that have been changed in size and shape.  Brush and floss daily.  After one or two weeks, you will return for a follow-up appointment for minor adjustments, if needed.

Have realistic expectations.  Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements.  It is not uncommon to see slight variations in the color of porcelain veneers upon close inspections, as this occurs even in natural teeth, Nevertheless, this procedure can greatly enhance your smile, and can heighten inner satisfaction and self-esteem.

**This information was compiled by the Academy of General Dentistry (AGD)

Grim news about the global financial crisis dominates headlines daily.  Consumer confidence is at its lowest point in history.  Even if your monthly income has not recently changed, you are probably looking at your household budget, trying to decide where you can cut back in personal expenses.  It only makes sense to prioritize spending and cut back on the things that just are not necessary right now.

Personal Reflection: All of us have ongoing expenses that we can certainly reduce or perhaps go without.  We want the item or service, but do we really need it?  On the other hand, there are things that we need but we don’t really want. In these hard times it is certainly easy to rationalize that you can’t afford something  you actually need if it isn’t something that is high on your emotional priority list.  Often health care falls into that category.  You need it but you don’t necessarily want it, and it is moved down the priority list when it comes to monthly spending.

Making Good Choices: Making the decision to reduce or eliminate health care in the short term during lean financial times can have long term repercussions.  There are very few procedures in dentistry that are preventive (or elective) or that can be delayed.  Often the public has considered regular hygiene visits (teeth cleaning), resin sealants, examinations and xrays as procedures that are preventive in nature and not totally necessary.  Nothing could be further from the truth.  Delaying any needed procedure, including a hygiene visit, will lead to more dental disease.   A delay in needed therapy will result in dental treatment that is more extensive, more expensive, and with a poorer prognosis. Often it leads to the loss of the tooth entirely.

90% of the dental diseases that we diagnose have no symptoms for the patient.  The decision to not treat the disease until you feel it can be a costly mistake.  Taking care of it now will be the most conservative treatment option, with the least expense and the best prognosis.

The doctor and your hygienist make a recommendation for the frequency of your dental cleanings based on your level of periodontal disease and your ability to control the bacterial levels in your mouth, as well as your medical conditions.  This is necessary to control or eliminate the dental disease process.  Every patient is different, therefore every patient’s frequency rate for cleaning and examination will vary.

The decision to spread out your regular dental visits for the sake of saving money in the monthly household budget may not be a wise choice.  It would be the equivalent of a diabetic deciding to take insulin every other day, or a high blood pressure patient deciding to skip his medication twice a week for the sake of saving money.  Could that decision create an unstable medical condition for the patient?  You bet!  The decision to delay or skip regular dental visits or needed treatment will create an unstable dental situation as well.

We Want To Help: We are dedicated to assisting our patients in achieving and maintaining excellent oral and systemic health.  We know that means not only providing the services necessary but also the information and education necessary for our patients to make good decisions about their care.  We know that also means working with each patient individually to find a way to comfortably afford treatment.  Let us help you with your questions and considerations during this unusual economy.

Invest In Yourself: The troubled financial times leave few places for an individual to securely invest their time and money.  While Wall Street is seemingly in a state of disarray, the financial institutions are lacking credibility and real estate investments have become unpredictable, your continued good health becomes your best investment.