My Blog
By Trish Palmeri, DDS
April 15, 2018
Category: Dental Procedures
EdenSherandtheLostRetainer

Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!

If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.

If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?

As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.

And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!

If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?

By Trish Palmeri, DDS
March 31, 2018
Category: Oral Health
Tags: fluoride  
3FluorideSourcesYouShouldMonitorforYourFamilysDentalHealth

Fluoride is an important weapon in the fight against tooth decay. Fluoride consumption and other applications are especially beneficial during children's dental development for building strong teeth long-term.

But the truism "too much of a good thing" could aptly apply to fluoride. If a child consumes too much fluoride over an extended period of time, it could cause a condition called enamel fluorosis in which the enamel surface develops mottled or streaked staining. It's not harmful to the tooth's health, but it can greatly diminish a person's smile appearance.

To avoid fluorosis, it's important with the help of your dentist to know and regulate as much as possible the amount of fluoride your child receives. Here are 3 fluoride sources you should manage.

Toothpaste. Many manufacturers add fluoride to their toothpaste formula, usually an important way to receive this tooth-strengthening chemical. But younger children tend to swallow more toothpaste than older children or adults. Because the chemical builds up in the body over time, swallowing toothpaste every day could potentially elevate your child's fluoride levels. To avoid this, just use a "smear" of toothpaste on the brush for children under age 2, and a pea-sized amount for older children.

Your water system. About three-quarters of all public water utilities add fluoride to their water as an added measure for tooth decay prevention. The amount can vary from system to system, although the maximum amount recommended by the U.S. Government is 0.70 parts per million (PPM). You can ask your local water system how much fluoride, if any, is present or they add to your drinking water.

Bottled water. Any type of bottled beverage (water, juices, sodas, etc.) could contain various levels of fluoride. Unfortunately there are no labeling requirements regarding its presence, so the most prudent course is to carefully manage the beverages your child drinks, or stay with bottled water marked "de-ionized," "purified," "demineralized" or "distilled," which typically have lower fluoride levels. For babies feeding on milk, you can use the aforementioned bottled waters to mix powder, use ready-to-feed formula (also low in fluoride) or breast-feed.

If you would like more information on fluoride and your baby, 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 “Tooth Development and Infant Formula.”

ComplicationsfromMissingTeethCouldLimitYourReplacementOptions

There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.

The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.

Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.

If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.

It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.

If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.

Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.

Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.

If you would like more information on dental restoration, please contact us or schedule an appointment for a consultation.

By Trish Palmeri, DDS
March 01, 2018
Category: Oral Health
GettheFactsAboutPopularArtificialSweeteners

Barley malt, corn syrup, maltodextrin — these and over fifty other label ingredients are all names for refined sugar. Under its various aliases, this sweet carbohydrate is tucked away in three-quarters of packaged foods in the U.S.

Although in recent years the general health effects from too much sugar have gained the spotlight, its effect on dental health has been known for decades. Accumulated sugar in the mouth is a prime food source for bacteria that cause tooth decay and gum disease.

For both general and oral health, people have been looking to artificial alternatives to satisfy their sweet tooth. But do they have their own issues that can impact overall health? Here is an overview of some of the more popular brands of artificial sweeteners and their effect on health.

Saccharin — One of the most widely used artificial sweeteners, saccharin is often used under the names Sweet’N Low or Sugar Twin in low-calorie foods because it contains no calories. According to the Food and Drug Administration (FDA) there are no associated health risks with consuming saccharin in recommended servings.

Aspartame — used commonly in beverages as Equal or NutraSweet, aspartame is unsuitable for cooking because its chemical structure breaks down under high heat. Although generally safe for consumption, it can affect people with a rare condition known as phenylketonuria that can’t adequately break down its chemicals.

Sucralose — marketed as Splenda, this sweetener is made by chemically altering refined table sugar so the body can’t process it. This may be one reason it has the most recognized natural flavor profile among consumers and is a market leader. It’s stable at high temperatures, so it’s often used in cooked or baked goods.

Stevia/Erythritol — this combination of an extract from the extremely sweet herb stevia and the sugar alcohol erythritol is marketed as Truvia. Unlike other calorie-free artificial sweeteners, this and other alcohol-based sweeteners have a low calorie level due to sugar alcohol’s characteristic of slow and incomplete absorption during digestion.

Xylitol — although all the previously mentioned sweeteners won’t promote bacterial growth like refined sugar, the sugar alcohol xylitol — often added to chewing gum and mints — has an added benefit: it may actually reduce levels of bacteria most likely to cause decay.

If you would like more information on the effect of sweeteners on dental 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 “Artificial Sweeteners.”

HowTeethWhiteningBringsOutTaraLipinskisWinningSmile

What does it take to win a gold medal in figure skating at the Winter Olympics? Years and years of practice…a great routine…and a fantastic smile. When Tara Lipinski won the women’s figure skating competition at the 1998 games in Nagano, Japan, she became the youngest gold medalist in an individual event in Winter Olympics history—and the whole world saw her winning smile.

“I love to smile, and I think it’s important—especially when you’re on-air,” she recently told Dear Doctor magazine. “I am that person who’s always smiling.”

Tara’s still skating, but these days you’re more likely to see her smile on TV: as a commentator for the 2018 Winter Olympics, for example. And like many other athletes and celebrities in the public eye—and countless regular folks too—Tara felt that, at a certain point, her smile needed a little brightening to look its best.

“A few years ago, I decided to have teeth whitening. I just thought, why not have a brighter smile? I went in-office and it was totally easy,” she said.

In-office teeth whitening is one of the most popular cosmetic dental procedures. In just one visit, it’s possible to lighten teeth by up to ten shades, for a difference you can see right away. Here in our office, we can safely apply concentrated bleaching solutions for quick results. These solutions aren’t appropriate for home use. Before your teeth are whitened, we will perform a complete examination to make sure underlying dental problems aren’t dimming your smile.

It’s also possible to do teeth whitening at home—it just takes a bit longer. We can provide custom-made trays that fit over your teeth, and give you whitening solutions that are safe to use at home. The difference is that the same amount of whitening may take weeks instead of hours, but the results should also make you smile. Some people start with treatments in the dental office for a dramatic improvement, and then move to take-home trays to keep their smiles looking bright.

That’s exactly what Tara did after her in-office treatments. She said the at-home kits are “a good way to—every couple of months—get a little bit of a whiter smile.”

So if your smile isn’t as bright as you’d like, contact our office or schedule a consultation to find out more about teeth whitening.  You can read more in the Dear Doctor magazine article “Important Teeth Whitening Questions Answered” and “Tooth Whitening Safety Tips.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.