My Blog

Posts for: January, 2018

By Trish Palmeri, DDS
January 30, 2018
Category: Oral Health
Tags: teeth grinding  
TeethGrindingCouldbeCausingYourTeethtobeLoose

There are a lot of reasons (including a blow to the mouth) why one of your permanent teeth might become loose. The most common: advanced periodontal (gum) disease that has weakened the gum attachment to the tooth.

There's also another, less common reason: you have a grinding habit that's producing higher than normal biting forces. Besides accelerating tooth wear, the constant jaw movement and teeth clenching can stretch periodontal ligaments and loosen their attachment to a tooth.

If the gums are disease-free, teeth grinding is most likely the main culprit for the damage, what we call primary occlusal trauma. Our treatment goal here is to reduce the effect of the grinding habit and, if necessary, secure the teeth with splinting while the ligaments heal. We can often reduce the grinding effect with a custom bite guard worn while you sleep. We may also prescribe minor muscle relaxants and mild pain medication like aspirin or ibuprofen.

Sometimes we may need to perform other measures like re-shaping your teeth's biting surfaces so they don't generate as much biting force. You may also benefit from counseling or other psychological treatment to help you address and cope with stress, a prime driver for teeth grinding.

Even if you don't have a grinding habit, biting forces may still contribute to tooth looseness if you have advanced gum disease. Advanced disease results in excessive bone loss, which in turn reduces the remaining amount of ligaments attached to the tooth. This type of damage, known as secondary occlusal trauma, and ensuing tooth looseness can occur even when your biting forces are normal.

It's necessary in these cases to treat the gum disease, primarily by manually removing plaque and calculus (hardened plaque deposits), which causes and sustains the infection. Once removed, the gums can begin to heal and strengthen their attachment. We may also need to apply splinting or perform surgical procedures to encourage gum and bone reattachment.

Whatever has caused your loose tooth, our goal is to remove the cause or lessen its effects. With your tooth secure and the gums regaining their healthy attachment, we have a good chance of saving it.

If you would like more information on teeth grinding and other potentially damaging oral habits, 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 “Loose Teeth: Biting Forces can Loosen Teeth.”


By Trish Palmeri, DDS
January 15, 2018
Category: Dental Procedures
Tags: dental implants  
ImplantPlacementintheSmileZoneRequiresExtraAttention

Dental implants are popular with both patients and dentists for their durability and likeness to natural teeth. That natural look, though, can be difficult to attain, especially in what’s known as the “smile zone” — the area of the mouth where teeth are most visible when you smile.

Our biggest concern is the upper front teeth, where the gums are most visible, especially if you smile widely. It takes considerable skill, experience and artistry to position implants in this area so that they appear to naturally emerge from the gums and blend well with other teeth.

To obtain that natural look, we must first assess whether or not there’s enough bone present, which tends to dissolve (resorb) when a tooth is missing, to sufficiently anchor the implant in the right position. There also needs to be sufficient bone around adjacent teeth to support the tiny triangles of gum tissue between teeth called papillae. Without the papillae an unattractive black hole may result between the implant and an adjacent tooth or implant.

Another factor we must consider is the type of gum tissue you have. Everyone generally inherits one of two types of tissue from their parents: thin or thick. The type you have can influence the way the implant appears to emerge from the gums. If you have thick gums, they’re easier to work with and can cover more of the implant. Thinner tissues aren’t quite as easy and are less forgiving if an implant isn’t placed as precisely as possible.

In recent years, improvements in implant design have sought to provide greater stability around bone and gum tissues to offset some of the issues we’ve mentioned. A variation on the design of the top of the implant (where the crown is attached) changes the direction of growth for gum tissues from a horizontal orientation to a vertical one, which can help with the final appearance.

The first step, if you’re considering dental implants for a tooth in the smile zone, is to visit us for a complete examination to see if any of these factors may have an impact on your situation. We can then advise you on the best course of action to achieve the most attractive smile possible.

If you would like more information on dental implants, 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 “Implant Aesthetics.”


By Trish Palmeri, DDS
January 07, 2018
Category: Oral Health
Tags: oral hygiene   oral health  
5TipstoKeepingaHealthyMouthDuringYourCollegeYears

Many recent high school graduates will soon begin their first year in college, and for many it will be their first time living away from home. But with the excitement of new freedom, there’s also the opportunity to make poor choices that could impact long-term health, especially teeth and gums.

Here, then, are 5 tips for keeping your teeth and gums healthy during the college years.

Watch what you eat and drink. At any stage of life, a nutritious, balanced diet low in sugar and high in fiber is vital to a healthy mouth. Snack moderately on fresh fruit, nuts or dairy foods, not sugary, processed products. Be sure also to drink plenty of water for hydration, not sodas or sports drinks whose high acid content can soften enamel and open the door to tooth decay.

Don’t abuse alcohol or use tobacco. Consuming too much alcohol can do more than leave you momentarily impaired — it can cause dry mouth, which contributes to tooth decay and increases your risk of oral cancer. Any form of tobacco can raise your risk for disease, especially oral cancer; high levels of nicotine may also inhibit your gum’s ability to fight infection, which increases your risk of periodontal (gum) disease.

Avoid oral piercings. Those tiny pieces of hardware attached to lips, tongue, gums or even through teeth may be all the rage, but they’re a recipe for immediate and future mouth problems. Oral piercings can lead to chipped teeth, gum recession and a higher chance of dental disease.

Practice safe sex. Certain sexual behaviors can raise your risk of contracting human papilloma virus (HPV16) that in turn increases your risk of oral cancer. You can also develop genital herpes in the mouth, which although manageable won’t go away.

Keep up your oral hygiene care. Taking care of your teeth and gums is a permanent, daily concern. Whatever your college schedule, be sure you’re brushing once or twice a day and flossing once. And don’t forget to visit us at least twice a year for a thorough cleaning (to get plaque you can’t reach with daily hygiene) and a checkup to keep dental disease under control.

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