Participating in athletic activities offers numerous well-documented health benefits — not to mention instilling the intangible values of discipline, teamwork and goal-setting. Of course, in nearly every sport, the possibility of injury exists as well. But don't let that stop you or someone you love from playing! Instead, you can learn about the potential hazards of dental injury, and take some practical steps to minimize the risk.

It should come as no surprise that injury to the mouth is an ever-present possibility in so-called “collision” sports like football and ice hockey. But did you know that the greatest number of dental injuries result from the games of baseball and basketball, which are often played informally? Even non-contact sports like skiing, bicycling and skateboarding carry a real risk of injury.

Who suffers dental injury? Men are slightly more likely than women — but only by a small percentage. Injury peaks in the teenage years, and seems to decrease afterward — but older athletes tend to have more severe problems. In short, most anyone who participates in sports is subject to possible dental injury.

Besides the obvious aesthetic imperfections, a damaged or missing tooth can also result in functional problems with the bite — a potentially serious condition. If a tooth can't be immediately replanted, restoring it can be expensive: The total cost of each tooth replacement is estimated at $10,000-$20,000 over a lifetime. So tooth damage or loss can cause a multitude of troubles.

The American Dental Association (ADA) has recommended that participants in all of the sports mentioned above — as well as two dozen others — should wear a custom-fitted mouthguard. Why? Because when it comes to dental injury, an ounce of prevention really is worth a pound of cure.

Numerous studies have shown that wearing a custom-fitted mouthguard is an effective way to prevent dental injury. According to the Academy of General Dentistry, mouthguards prevent some 200,000 injuries each year. And the ADA says that athletes who don't wear mouthguards are 60 times more likely to sustain harm to the teeth than those who do wear them.

Off-the-shelf mouthguards in a limited range of sizes are available at many sporting-goods stores. But these can't compare to the superior protection and durability offered by a mouthguard that's custom-made just for you. Using an exact model of your teeth, we can individually fabricate a piece of protective gear that fits correctly and feels comfortable in your mouth. A custom mouthguard may be more economical than you think — yet its real payoff comes in preventing dental injury.

If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

When it comes to childhood injuries — cuts and scrapes, growing pains, even wounded pride — it's often a parent's job to try and make things better. But sometimes it's hard to know whether the hurt indicates a serious problem, or if it's a situation that will resolve itself as soon as the sun comes up. If pain is being caused by a toothache, here are some general rules that can help you figure out what's the best thing to do.

1. Unless it's accompanied by fever and swelling, a child's toothache isn't generally an emergency.

The first thing to do is calm down (both you and the child) — and talk! Find out exactly where the pain comes from, and when and why it might have started. (Your child may have forgotten to tell you about that fall in the gym...) Sometimes, a little sleuthing will give you a clue about what's causing the pain.

2. Tooth decay, a bacteria-induced infection, is the most common cause of toothaches.

Check the teeth for brown spots or tiny holes (cavities) which might indicate decay — especially on the biting surfaces and in the areas between teeth. Next, look at the gums around the hurt tooth. If they show cuts or bruises, that's a sign of trauma. If you see only swelling, it may indicate the formation of an abscess.

3. If nothing looks obviously wrong, try gently flossing both sides of the tooth.

This may dislodge a bit of trapped food or candy, and relieve the pressure and soreness. But if that doesn't help, remember that some conditions — like nerve damage inside the tooth, for example — may have no apparent symptoms except pain.

4. Treat pain with an appropriate dose of acetaminophen or ibuprofen.

Base the dose on your child's age and weight, according to the medication's instructions. You can also apply an ice pack (one minute on, one minute off) to the outside of the jaw. But NEVER rub aspirin (or any painkiller) directly on a child's gums: It can cause burns and severe discomfort.

5. Pain that keeps a child awake at night, or persists into the next day, needs professional evaluation as soon as possible.

Otherwise, unless the pain resolves quickly and you're sure you know exactly what caused the toothache, it's best to bring your child in for an examination as soon as it's practical. You'll feel better having a dental professional, backed with years of experience and training, taking care of your child's health — and you just might prevent a future problem.

If you have questions about toothaches in children, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “A Child's Toothache.”

Porcelain laminate veneers are one of the innovative techniques dentistry has developed for restoring teeth to improve their color and shape so that they look as good as or better than the originals.

What are porcelain veneers? Porcelain is a ceramic material that is baked in a high-heat oven until it becomes glass-like. Your grandmother's antique china teacups are probably made of porcelain. Dental porcelains are especially made to perfectly mimic the color, reflectivity and translucency of natural tooth enamel. A veneer is a covering or shell, a false front; dental porcelains can be fashioned into veneers used to restore the enamel surfaces of teeth.

What is a laminate? A laminate is a structure created by uniting two or more layers of material together. Dental porcelain laminate veneers refer to the combination of tooth enamel bonding material and porcelain veneer.

When are porcelain laminate veneers used? Porcelain veneers are used to enhance the color of stained, darkened, decayed and heavily restored teeth. They are also used to: correct spaces between teeth; straighten slightly rotated teeth; correct problems in tooth shape and some bite problems. They can be good solutions for broken teeth or teeth that have been worn by habitual tooth grinding.

What is the process of placing the veneers? Room generally needs to be created to place a veneer; generally requiring about half a millimeter of reduction of tooth enamel. Artistic dental laboratory technicians fabricate veneers. About a week of laboratory time is usually needed to construct your veneers.

How do I know whether I will like the way my new veneers look? Computer imaging can be used to digitally replicate your teeth and create images of the proposed changes. Models of your teeth can be cast and changes can be made in white wax for your preview. Temporary veneers can also be fabricated as a test drive before the final veneers are fabricated.

How long will porcelain veneers last? Veneers can last 20 years or more. They are very strong but like glass, they can break if extreme force is applied to them. You should avoid such activities as opening bottles, cracking nuts, or biting into candy apples with your veneers.

How do I look after my new veneers? Once the veneers are placed, you should continue daily brushing and flossing. There is no higher incidence of decay around them than with your natural teeth. However, the more dental work you have in your mouth, the more vigilant you need to be. Of course, keeping your sugar consumption low helps to protect all of your teeth from decay.

Contact us today to schedule an appointment or to discuss your questions about porcelain laminate veneers. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”

Is it a root canal problem, a gum infection, or both?

Sometimes it's difficult to pinpoint the source of tooth pain; it can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Identifying the origin of a toothache is important, however, so we can choose the right treatment and do all that we can to save the tooth.

When a tooth becomes decayed, bacteria can infect the sensitive, living nerve tissue deep inside the tooth known as the root canal. This condition is called an endodontic (“endo” – inside; “dont” – tooth) problem. The infection inside the tooth can spread to the periodontal ligament (“peri” – around; “dont” – tooth) that encases the tooth and attaches it to the jawbone. Occasionally, infection of endodontic (root canal) origin can spread out from the end of the tooth root all the way up the periodontal ligament, and into the gum.

The reverse can also happen: dental pain can originate from periodontal (gum) tissues that have become diseased. Gum disease is caused by a buildup of bacterial biofilm (plaque) along the gum line. It results in detachment of the gums along the tooth surface. In advanced cases, this bacterial infection can travel into the nerve tissues of the dental pulp through accessory canals or at the end of a tooth.

To figure out where pain is coming from when the source is not obvious, we need to take a detailed history of the symptoms, test how the tooth reacts to temperature and pressure, and evaluate radiographs (x-ray pictures).

Unfortunately, once dental disease becomes a combined periodontal-endodontic problem, the long-term survival of the tooth is jeopardized. The chances for saving the tooth are better if the infection started in the root canal and then spread to the gums, rather than if it started as gum disease that spread into the root canal of the tooth. That's because in the latter case, there is usually a lot of bone loss from the gum disease. Effectively removing plaque from your teeth on a daily basis with routine brushing and flossing is your best defense against developing gum disease in the first place.

If you would like more information about tooth pain, gum disease or root canal problems, please contact us or schedule an appointment for a consultation. You can also learn more about this diagnostic dilemma by reading Dear Doctor magazine's article “Confusing Tooth Pain.”

In our office, many of our patients are always asking us if over-the-counter (OTC) mouthwashes or mouthrinses are truly effective tools for curing bad breath. Unfortunately, nearly all of them merely mask any odorous smells temporarily — regardless of how refreshing they taste. There are mouthrinses available that are effective for treating gingivitis and tooth decay, but you must visit our office to obtain a proper diagnosis and a prescription for them. Reality is that a mouthrinse alone can't cure bad breath; however, there are products available that can make a positive impact on your dental health. The key is to match the right mouthrinse to your specific dental need.

• OTC mouthrinses that contain about 0.05% sodium fluoride are an effective tool that when combined with good oral hygiene can significantly reduce the development of tooth decay.
• OTC mouthrinses that contain alcohol, triclosan, sanguinaria extract, zinc and/or essential oils such as menthol can somewhat help reduce the bacteria in plaque, which in turn can reduce gum inflammation (gingivitis) and bad breath when used in combination with proper brushing and daily flossing.
• Prescription mouthrinses containing chlorhexidine may be more effective in helping to control both gingivitis and tooth decay in certain circumstances. This is because chlorhexidine inhibits the formation of dental plaque by preventing bacteria from sticking to your teeth.

While bad breath may seem unbearable, it is often treatable. The key is to determine and then address what is causing your bad breath. A simple trip to our office for a proper exam, assessment and thorough cleaning along with improved oral hygiene may just do the trick. Contact us today to schedule a consultation for an examination and treatment plan.

Learn More

To learn more about mouthrinses, read the Dear Doctor article, “Mouthrinses.”

Are you are considering a cosmetic procedure such as porcelain veneers? To assist you in making this decision, we developed the following list of questions you should consider asking before getting porcelain veneers.

• Am I a good candidate for porcelain veneers?
• Can you show me examples of your work?
• How much will my veneers cost?
• Will my insurance cover any portion of my procedure?
• Do you offer any financing for my procedure or can you make any recommendations for financing?
• Can you create a computer-generated image or mock-up of what my new smile will look like?
• How will you chose what color to make my veneers?
• How long will it take from my initial consultation until I receive my final, permanent veneers?
• How much tooth reduction (drilling) will you need to do before placing my veneers?
• How do veneers attach to my teeth?
• Can you create a prototype or temporary veneers so that I can “test drive” my new smile before my permanent ones are made?
• What do I need to do to clean and protect my veneers?
• How long can I expect my veneers to last?
• If at some point in the future I decide I want my veneers removed, what can I expect?

We hope that the above questions help you obtain all the answers you need as you consider getting porcelain veneers. If you have other questions, concerns, or if you are ready to take the next step and schedule a consultation, please contact our office.

It used to be that when it came to treating tooth decay (cavities), your primary option was to have the tooth decay removed and filled with a metal amalgam (silver-colored filling). This treatment sometimes requires a special shape cut called an “undercut” to be drilled into the tooth to hold it in. Unfortunately, it can also involve removal of some healthy tooth structure. Silver amalgam fillings still have limited applications and are still used in back teeth where they don't show in the smile. This is because they are strong and resist biting well; however, over time they can fatigue and fracture.

Older restorative concepts were based upon the development of strong and stiff materials such as gold, which tends to be unyielding and therefore contributed to failures of the remaining tooth substance around restorations (e.g., decay or cracking). Newer concepts tend to get away from the “stronger and stiffer is better” concept and have moved towards safety principles using materials that involve mimicking the properties of natural tooth structure. In fact, it is now clearly established that a new “biomimetic approach” (“bio” – life; “mimetic” – mimicking) to dentistry is possible through the use of tooth-like materials such as composite resins and porcelains. And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, which both stabilize and strengthen teeth.

These techniques are also suitable for children's teeth and can incorporate fluoride to reduce further decay. But perhaps best of all, using these materials and more modern technologies can restore proper tooth function and normal wear while producing results that appear indistinguishable from natural teeth.

To learn more, continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” You can also contact us today to schedule an appointment to discuss your specific questions about replacing your metal fillings with tooth-colored ones.

If you don't like your smile when you look in the mirror, or feel self-conscious because your teeth are discolored, there are a variety of whitening procedures that can help you obtain the smile of your dreams.

Choosing the Right White: With strips, trays and toothpastes all claiming to be the best tooth whitening systems, it can be hard to choose how to whiten your teeth. Our office can help you decide the best approach based on your individual needs, time constraints and budget. Whiteners may not correct all types of discolorations.

Whitening in Our Office: This procedure is called chair-side or professional bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour. We use an in-office whitening gel that is professionally applied to your teeth and activated by a light source, giving you significantly whiter teeth in less than an hour. Typically, teeth with a yellowish hue respond best to whitening.

Whitening Your Teeth at Home: If you are an adult who practices good oral hygiene and doesn't suffer from periodontal disease, our office can help you decide whether an at-home whitening system, or having your teeth whitened in our office best meets your needs. If you decide to go with an at-home system, you will wear a custom-made whitening tray that looks like a thin, transparent night guard. You fill the tray with a mild whitening gel and need to wear the gel filled tray for a specified period of time each day (per our office's instructions). This procedure must be continued over a period of time that generally extends from 2-4 weeks.

Whitening Products Found in Stores: If you are considering over-the-counter whitening products we can also recommend products that will offer you the best results. Whitening toothpastes that have the American Dental Association (ADA) Seal of Acceptance contain special chemical or polishing agents that generally provide some stain removal effect.

Contact us today to schedule an appointment or to discuss any questions that you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening.”

Root canal, or endodontic (“endo” – inside; “dont” – tooth) treatment, is often wrongly perceived as a highly unpleasant experience and one that causes tremendous pain. However, the truth is that the procedure actually relieves the pain being caused by an infected and inflamed tooth pulp (inside of the tooth). Advances in dentistry have made treatment virtually pain free and it can be completed relatively quickly, usually in a single visit. Left untreated, infection can spread into the bone immediately around the tooth's root, so prompt attention is the best course of action.

If the term “root canal” still sends shivers down your spine, don't despair. Here is some information that should help put your mind at ease.

• Root canal treatment is necessary when deep decay or trauma has caused the inside (pulp) of the tooth to become inflamed or infected. Symptoms of infection can include sharp pain when biting down, lingering pain after consuming very hot or cold foods, a dull ache and feeling of pressure near the infected tooth, and tender gum tissue surrounding the infected tooth.
• After a local anesthetic is administered to numb the infected tooth and its surrounding area, we will make a small opening on the chewing surface of the tooth. This will allow us to remove dead and dying tissue from the pulp and to then clean and disinfect the root canals. Using small instruments, we will shape the canals and seal them with biocompatible filling materials.
• You may feel slight tenderness at the treated site for a few days, but this is quite manageable and can be relieved with over-the-counter (OTC) non-steroidal, anti-inflammatory pain relievers such as aspirin or ibuprofen. You should refrain from chewing on the treated tooth until your follow-up appointment. A crown or other restoration may be needed to protect the tooth and restore it to full function.

If you think you might be a candidate for a root canal treatment, schedule an appointment as soon as possible. If you would like to learn more about the process of root canal treatment, please read the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”

How many of these questions can you answer correctly? The more you know about nutrition and oral health, the healthier you are likely to be.

What are free sugars?
“Free sugars” is a term for sugars including refined cane, beet and corn sugar, which are added to foods or occur naturally in honey, syrups or fruit juices.

You probably know that foods with added sugars are not healthy for your teeth. What is the maximum recommended sugar intake for oral health?
The recommended daily limit for free sugar is 10 teaspoons per day. Note that one can of soda contains over 6 teaspoons.

If a sugary snack is bad for your teeth, what could you substitute that would be better?
Fresh fruits and vegetables would be a better snack. Fresh fruits contain fructose, a sugar that has not been shown to be harmful to teeth if eaten in reasonable amounts.

How can you get enough fluoride to guard your teeth against decay?
If your water supply does not contain fluoride, or if you usually drink bottled water, you may or may not be receiving enough fluoride from your toothpaste. We can assess if you are receiving enough fluoride by examining your teeth, testing your plaque and reviewing your past history of tooth decay. If you are having a problem with tooth decay, we can create fluoride trays for you so you can apply a fluoride solution to your teeth daily.

What is dental erosion and how is it different from tooth decay?
Some acidic foods, particularly drinks such as juices and sodas, wear away your teeth's outer coating (the enamel) when exposed to the teeth's surface. Erosion does not involve bacteria, the cause of dental caries (tooth decay).

Can certain foods stop acidity from attacking your teeth?
Yes, there are foods that reverse the increase in acidity that comes from eating free sugars. One of these is cheese. Cheese stimulates saliva in your mouth, and it contains high levels of calcium, allowing calcium to be added back to your teeth. Many vegetables and starchy whole grain foods require thorough chewing, which also stimulates production of saliva and guards against tooth decay.

We hope you learned some useful facts from this nutrition quiz. If you modify your habits so that you eat less free sugar; drink more water (preferably fluoridated), drink fewer juices and sodas; and snack on fresh fruits, vegetables, and cheese, you can count on having healthy teeth and gums.

Contact us today to schedule an appointment to discuss your questions about diet and oral health. You can also learn more by reading the Dear Doctor magazine article “Nutrition & Oral Health.”

Since the dawn of man, periodontal (gum) disease has impacted humans. And while dental health has dramatically improved over the generations, the facts are still clear — millions of Americans are suffering from gum disease and probably do not even know that they have a problem. This is because periodontal disease most often starts without any symptoms or ones that most people tend to discount or ignore.

Stage 1: Gingivitis. The first stage of gum disease is inflammation of the gingiva (gums) without bone loss. While nearly all people will develop gingivitis in the absence of good oral hygiene, only 10 to 15% of them will go on to develop more advanced stages of the disease.

Stage 2: Early periodontitis. With this stage, gingivitis progresses into the deeper periodontal structures — the tissues that attach the teeth to the bone resulting in early or beginning bone loss. About 10% of the population develops full-blown periodontitis with progressive bone loss.

Stage 3: Moderate periodontitis. The third stage of gum disease results in moderate bone loss (20 to 50%) of root surfaces of the teeth due to continued destruction of the surrounding tissues and bone. Periodontal disease is “cyclical” — it goes in cycles with bursts of activity, followed by a period in which the body tries to recover. This is called chronic inflammation, or frustrated healing.

Stage 4: Advanced periodontitis. With the final stage of gum disease, there is severe bone loss (50 to 85%) from the tooth's root. This stage includes looseness of teeth, moving teeth, abscess formation with red, swollen and painful gums. The end results — eating and even smiling is difficult and uncomfortable, and you could lose all your teeth.

You can learn more about gum disease in the Dear Doctor article, “Understanding Gum Disease.”

Have We Described Your Mouth?

If any of the above stages sounds like we are talking about your mouth, contact us today to schedule a consultation, discuss your questions and receive a thorough exam. If addressed promptly and with commitment to following your treatment plan, your mouth can return to good oral health.

When speaking about veneers in dentistry, many people wonder what they are really made from and how they produce such natural results. The answer is dental porcelain...and yes, it really is a type of porcelain or glass. Even though they are made of porcelain, not all porcelains are the same. This is one reason there can be such a wide price range when comparing porcelain veneer pricing from one dentist to another. For example, the quality of the dental porcelain used and the expertise of the dental lab artisans greatly impact the price of a veneer — just like other pieces of fine art, pricing depends upon the materials used and the artistry of the person creating them.

Dental porcelains are used to create veneers because of their near ideal optical properties in mimicking natural teeth in shine, opacity, and translucence. And when you combine these facts with the artistry of the lab technician and your dentist skill's in placing the veneers, you begin to understand how veneers are virtually undetectable in cosmetically-enhanced teeth. Another reason for using dental porcelain is that they can be made in many colors, shades and translucencies to enhance the optical properties and natural beauty of whiter, brighter, and visually appealing teeth. However, do not let the word porcelain, fool you when it comes to durability. While veneers are not as strong as natural teeth they are not so fragile that you should worry about breaking or damaging them with normal wear and tear. However, you should avoid biting into extremely hard substances; using your veneers as a tool in lieu of scissors, tweezers, or pliers (you should not use your natural teeth as a tool either!); and twisting your veneers when biting into harder substances.

To learn more about veneers, continue reading, “Smile Design Enhanced With Porcelain Veneers.” Or, contact us today to discuss your questions or to schedule a consultation.

Expectant mothers expect to deal with tooth-related milestones in their child's early years, such as teething and even the eventual shedding of those baby teeth to the Tooth Fairy. But there are many facets of children's oral health that may not be as well known. For example, did you know that using sugary fluids in your baby's bottle too frequently could promote constant acid production in your child's mouth leading to early childhood decay? Did you know that parents and caregivers who have decay transmit the bacteria that cause decay to their children?

Baby or primary teeth serve as guides for permanent teeth and, therefore, their health sets the stage for the health and proper function of their permanent successors. A comprehensive examination during a child's first visit can help uncover any underlying conditions that might be indicative of future problems, like tooth decay that can start as early as the age of six months when their first teeth appear. So the “Age One Visit” is the right time for a first dental visit.

What else do you know or want to know? Take our short quiz to help your child. The answers are listed at the bottom of this article.

The Quiz

1. Mounting evidence suggests that a child's oral health is most closely tied to which relative?
1. Mother
2. Father
3. Brother
4. Sister
2. Parents should bring their children to see a pediatric dentist:
1. Once they turn two?
2. Before they start kindergarten?
3. Preferably before their first birthday?
4. When they start to lose their baby teeth?
3. Tooth decay that occurs in infants and young children is referred to as what?
1. Primary tooth decay
2. Early Childhood Caries
3. Diapers to Decay Disease
4. Pediatric Dental Caries Syndrome
4. To help diminish the likelihood that your baby/infant will develop a cavity, you should:
1. Restrict the amount of sugary fluids your child drinks to mealtimes
2. Maintain proper oral hygiene to reduce harmful bacteria
3. Use fluoride to make the teeth more resistant to acid attack
4. All of the above
5. Infants are most susceptible to tooth decay when:
1. Breast feeding
2. Drinking milk from a bottle during meal times
3. Sucking on a pacifier that has been dipped in jam
4. Sleeping on their sides

The Answers

1) a = mother 2) c = before their first birthday 3) b = early childhood caries 4) d = all of the above 5) c = sucking on a pacifier that has been dipped in jam

Your baby's first visit to the dentist will cover a lot of ground, including diagnosis, prevention, education, and treatment as we help start him or her on the path to long-lasting oral and dental health. Call our office to schedule an appointment now. You can also learn more about pediatric tooth decay by reading the Dear Doctor magazine article “Age One Dental Visit — Why It's Important For Your Baby.”

Anytime you are considering an implant surgery to replace missing teeth, you should take the time to gather the facts so that you have clear understanding of the procedure, your options and any potential risks. You should also feel comfortable with the dental team who is treating you. For these reasons, we created the following comprehensive list of questions so that you can obtain the answers you need to help you feel at ease prior to treatment.

• Am I a good candidate for dental implants?
• What is the success rate for dental implants?
• How long have you been placing implants and how many do you place each year?
• Can you show me some before and after photos that illustrate your work?
• What are the risks, benefits and alternatives to dental implants?
• Are dental implants ever rejected?
• How do you assess whether I have enough bone to anchor dental implants?
• Can you tell me about the surgical procedure for implant placement?
• How long will the entire process take from my first appointment until I have my implant(s) and crown(s) in place?
• Do I have to go without teeth while my implants are healing?
• What type of anesthesia will you use during my implant surgery?
• What can I expect in the hours and days following my implant surgery?
• How long will it take my implants to heal?
• How long can I expect my implants to last?
• Will there be any maintenance required with my implant(s)?
• How much will dental implant(s) cost?
• Will my insurance cover all or a portion of the cost?

To learn more, read “Dental Implants, Evaluating Your Professional Options For Care.” Or, you can contact us to discuss your questions or to schedule an appointment.

If you fear a visit to the dentist, you are not alone. Studies have shown that up to 75% of people surveyed have some fear of dental visits, and 10 to 15% fear the dentist so much that they avoid any dental treatment. This can have serious repercussions, leading to toothaches, infections, and loss of teeth. Poor oral health can even negatively affect your general state of health.

Here's the good news. Even people who are the most afraid of the dentist can learn to reduce their fear and feel calm and safe during a dental visit.

Dental fears develop when people have bad dental experiences. For many, the problem is a sense of loss of control. Sometimes, fears are based on stories people have heard or even movies they have seen.

The feeling of being afraid reinforces your fear. If you experience the rapid heartbeat, sweaty palms, tensed muscles, and other symptoms of fear while in the dentist chair, you are likely to remember these unpleasant feelings afterward and become even more fearful. In order to reverse this process, you need to begin to associate dental visits with good experiences and a sense of control. Here's how we can help you do this:

• Know that you are not alone and we are here to help you.
• Talk to us about your fears. We are sure to listen and not be judgmental. If you don't talk about it, you can't get over it.
• We will start by doing things that cause only mild or no anxiety. We want each visit to be a good experience, so you are able to leave our office with a feeling that it was okay, and you can do it again.
• Our goal is for you to overcome your fear. We will make this a priority and that priority is as important as “fixing your teeth.” We will be happy to talk about the time and fees associated with your treatment so that you can overcome your fear and gain a sense of control of the situation.
• It took a while for your fears to develop, so you should realize that it will also take a while to get over them. We will spend as much time as you need to get over your fears and will not rush you into doing anything for which you are not ready.

Contact us today to schedule an appointment to discuss your questions about any fears you may have. You can also learn more by reading the Dear Doctor magazine article “Overcoming Dental Fear & Anxiety.”

Oral sedation can be an ideal and safe solution for someone who suffers from fear and anxiety regarding dental appointments — the very reason we offer it to our patients. However, there are some things you need to do prior to and following your treatment for optimal oral sedation benefits and treatment results.

• Being completely honest about your health history and any medication you are taking is a critical aspect, as it lets us know that oral sedation medication is safe and will work for you. We also ask you to let us know about any over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. The reason this is so vital is that some can negatively impact your treatment, recovery, and the effectiveness of the oral sedation medications.
• You should not eat or drink anything six hours prior to your appointment unless we instruct you otherwise.
• You should make arrangements to have someone drive you to and from your appointment, as it may not be safe for you to drive or operate any heavy machinery until the effects of oral sedation have worn off. It is important to note that this will vary depending on what medication is used, so do not assume your reaction/response will always be the same.
• Drink plenty of fluids (especially water) to stay hydrated after your appointment.

To learn more ways you can prepare, read the article “Oral Sedation Dentistry.” Or you can contact us today to discuss your questions or to schedule an appointment.

If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.

Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.

Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.

Advantages of prepless veneers include:

• Tooth preparation or reduction is not needed, leaving the original tooth whole.
• They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
• They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
• They can be used to “lengthen” teeth that have been worn down by grinding.
• Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.

Disadvantages include:

• There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
• Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
• Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
• They do not usually work for lower teeth because of space restrictions.
• They cannot replace lost or damaged enamel.

Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.

Contact us today to schedule an appointment to discuss your questions about prepless veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”

If you are unhappy with your smile or the way some of your teeth appear, porcelain veneers may be the solution to your concerns. They are a fast, effective, and well-proven method for cosmetically enhancing your smile — and a secret that Hollywood and other celebrities have been taking advantage of for years. To help you determine if they are right for you, here are some questions we typically receive.

What is a veneer?

A veneer is a custom made thin “shell” or thin layer of a dental ceramic material (usually porcelain) used to replace the front, visible surface of the tooth. They are artistically and hand-crafted using a precise model of your mouth and teeth to achieve a natural look.

What can they do for me?

Veneers are the optimal choice for correcting small to medium gaps between teeth; slight rotations of teeth causing them to be misaligned; oddly shaped, chipped, or “short” teeth; as well as teeth that are discolored or unevenly colored. However, veneers have their limitations, too. They cannot correct bite issues, poor tooth position, or profile issues. It is also important to note that if you have this procedure, we will typically need to remove a small amount of enamel from your teeth to accommodate the veneer and produce dramatic improvements to your smile.

How long will they last?

While they can vary widely from person to person, porcelain veneers usually last from 7 to 20 years. Factors that impact this timeline include your oral hygiene habits, diet, lifestyle, as well as how well you protect your veneers during sleep and while playing sports.

Have more questions?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about veneers by reading the Dear Doctor article, “Smile Design Enhanced With Porcelain Veneers.”

While the goal of restorative dentistry is to return all of the destroyed or lost dental tissues of the teeth to full form (shape) and function, when you blend this goal with the artistry of cosmetic dentistry, the results can be dazzling. Today's modern techniques and materials enable replacement of missing tooth structure that allows bonding directly to the tooth so that it not only is an exact color match but also actually strengthens the tooth. And tooth-colored fillings are not just for front teeth. They can dramatically improve the appearance of all teeth — even your back molars — so that it appears you've never had tooth decay at all!

All of this is accomplished through the use of either tooth-colored dental porcelain or composite resins. Porcelains are a form of ceramic material formed by the action of heat. They are available in many colors and shades made from a powder corresponding to the primary color of the natural tooth structure that is mixed with water and placed into an oven for firing (hence their ceramic nature). When built up in layers by highly trained dental ceramicists, they can be made to mimic the exact natural translucency, staining and contours of tooth enamel.

Dental composite resins are the most common materials used for tooth-colored adhesive restorations today and have properties similar to tooth structure. They consist of resin or special plastics and fillers that are made of silica, a form of glass. The fillers give the composites wear resistance and translucency (see through properties).

It is important to note that besides providing the appearance of beautiful teeth, properly restored teeth function and wear better. But most important to you, they appear indistinguishable from natural teeth! Furthermore, scientific studies and clinical experience have validated their use as both safe and predictable. In fact, these techniques are also suitable for children's teeth and can incorporate fluoride to reduce decay. Together, all of these changes have so significantly impacted the way modern dentistry is practiced that many believe we may have entered into the so-called “post-amalgam (silver metal-colored dental fillings) era.”

Contact us today to schedule an appointment to discuss your questions about tooth-colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”

While we have gained recognition for our role in creating gorgeous smiles with porcelain veneers, the often overlooked or unknown key contributors in this process are the dental laboratory technicians. These behind-the-scenes artists are the trained professionals in the art of using dental porcelain to hand-craft veneers and crowns into near exact replicas of natural teeth in shine, opacity, translucence and shape.

Through the use of precise molds and excellent communication skills, we share detailed information with the laboratory technician to create veneers or crowns specifically for enhancing and improving your smile. In fact, communication must be so exact that it often demands correct lighting, cameras and computers to produce optimal results. This process also requires a variety of colors, shapes and translucency, created so that once we cement them into place, they appear as beautiful natural teeth. If your veneers are part of a smile restoration or makeover and you are getting them for several front teeth, the end results are typically brighter and whiter than your natural teeth. However, they must blend with surrounding teeth if those teeth are not also receiving veneers. So it is often recommended to have your natural teeth whitened before the veneers are replaced.

Good dental porcelains in the right hands can make for spectacular tooth imitations by mimicking tooth enamel perfectly. And now that you have these facts, you begin to understand all of the expertise, artistry, and the technology required by laboratory technicians to produce the most dazzling porcelain veneers.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Smile Design Enhanced With Porcelain Veneers.” Or if you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.