DiMariano Family Dentistry Blog

Posts for: April, 2013

By Drs. Jeff DiMariano & Shaina DiMariano
April 27, 2013
Category: Oral Health
SecondThoughtsonTonguePiercingShouldYouRemoveYourTongueBolt

It was one of those things that seemed like a good idea at the time. Maybe it was years ago, or maybe it was yesterday — at some point in your past life you had your tongue pierced and a metal bolt inserted. But now you are wondering whether you made a bad decision. If you have the bolt removed from your tongue, will your mouth go back to being the way it was before the piercing?

The answer is yes, your oral health will improve when you remove a tongue bolt. There are many reasons for this. Your tongue has a rich blood vessel supply to fuel its energy needs and heals quickly.

Some people suffer from chronic pain as long as the bolt is in place. In addition to pain, tongue piercing is associated with other risks. The bolt can chip your teeth or cause tooth sensitivity. It can also cause your gums to recede from your teeth. You may also suffer from inflammation and infection in your gums. This can lead to bone loss and ultimately to loss of teeth.

A piercing and tongue bolt can also cause damage to the nerves in your tongue. This causes pain for some people until the bolt is removed. Your tongue is well supplied with nerves as well as blood vessels. That is why biting your tongue hurts and bleeds a lot, another good reason for not having a piercing.

So what happens if you have the bolt removed? In most cases conditions in your mouth will return to normal. We will want to monitor your condition after removing the bolt to make sure it has not caused collateral damage to your gums and teeth and other oral structures.

Removing the bolt will leave your tongue with a hole that is likely to close spontaneously. If it does not close, a small surgical procedure can remove the skin that lines the holes, which are then stitched closed. This procedure is done with local anesthesia so you don't feel anything, and healing is usually quick and without complications.

If you are having second thoughts about a tongue piercing, it's time to make an appointment for a consultation with us. You can also view the Dear Doctor magazine article “Oral Piercing.”


By Drs. Jeff DiMariano & Shaina DiMariano
April 20, 2013
Category: Dental Procedures
Tags: retainers   orthodontics  
TheTop5ThingstoKnowAboutOrthodonticRetainers

Whether they come as removable devices or wires permanently attached behind the front teeth, orthodontic retainers have a crucial job to do in your mouth. Here's the skinny on what you ought to know about them.

1) Retainers keep your new smile looking the way it should.

After having braces to move your teeth into the desired position, a retainer is needed to keep them from moving right back where they were! In time, the periodontal (“peri” – around; “odont” – tooth) structures, which are constantly renewing themselves, will adapt to their new positions, and the teeth will stabilize.

2) There are different types of retainers.

Once upon a time, retainers were made of pink plastic and bent wire, and were removable. They're still available — but a common alternative today is to have clear retainers that fit onto your teeth covering them entirely or to have thin wires bonded to the inside of the front teeth They don't show, and you don't have to worry about putting them in and taking them out. If you prefer, ask us whether this type of retainer would work for you.

3) It takes several months for your teeth to become stable in a new arrangement.

Teeth must be held in position long enough for the bone and ligament that attaches them to the jaw to re-form and mature around them. A retainer helps avoid trauma as the teeth and associated structures are adjusting to relocation, allowing the process to end slowly and gently.

4) Even when they're stable, your teeth are always in a “dynamic” state.

There is some “memory” inherent in bone and gum tissue, which tends to cause teeth to shift back to their former positions for a long period of time after treatment. But teeth aren't held in place just by bone and ligament — a balance between the forces of the lips, cheeks and tongue also helps them stay put. This balance changes over a period of time.

5) The movement of teeth is unique to each person, and is not predictable.

Contrary to what orthodontists used to believe, there is no “right” position for the teeth that assures they will stay in place permanently. In time, the position of the teeth may change due to a slow “uprighting” movement of the front teeth in the lower jaw, which causes them to crowd as they move toward the tongue. Other factors may also cause a gradual movement of the teeth. But remember to always follow our recommendations; they will help keep your smile looking its best.

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


By Drs. Jeff DiMariano & Shaina DiMariano
April 12, 2013
Category: Oral Health
Tags: toothache   tooth pain  
WhyYourTeethMayHurt

Don't ignore tooth pain hoping it goes away. No matter how mild or fleeting it may be, it's a sign that something's wrong. Healthy teeth shouldn't cause discomfort because the parts containing the nerves — the interior pulp and the dentin around it — are shielded by dental enamel and gums.

Here are some common reasons that teeth ache:

  1. Gum Recession. Over time, gums can recede. Improper or excessive brushing can affect them, especially if you are genetically predisposed by having thin gums. When gums retreat, dentin can, or eventually will, be exposed. Besides its susceptibility to sensation, dentin is also more vulnerable to erosion and decay than enamel.
  2. Tooth Erosion/Decay. When acid-producing oral bacteria get the upper hand, they can eat through the tooth's protective enamel to the dentin. You may start feeling sensitivity as the decay gets deeper and closer to the pulp (nerves). Only removal of the decay and filling the cavity can stop the process.
  3. Old/Loose/Lost Filling. Fillings seal off areas of past decay. If they don't fit right or are dislodged altogether, air or food particles can slip inside and irritate exposed nerve endings. A crevice to hide in makes it prime real estate again for bacteria, too.
  4. Cracked Tooth. Teeth grinding and jaw clenching can have a similar impact on teeth that a miner's pick has on rock. At first thin lines in your enamel can develop, then cracks develop that may expose the dentin, and finally the tooth might fracture, exposing the pulp. The earlier this process is caught, the better.
  5. Pulp Tissue Infection/Inflammation. This can be caused by deep decay or trauma and suggests your tooth may be in its death throes. Sometimes the pulp infection travels into the surrounding periodontal (peri – around; odont – tooth) tissues and causes an abscess to develop. This absolutely requires immediate attention.
  6. Residual Sensitivity from Dental Work. Removal of decay before placing a filling can cause tooth sensitivity. It can take 1-4 weeks or so to improve.
  7. Sinus Pain. Congestion can cause “referred” pain in the upper teeth. When the congestion subsides, the pain should, too.

As you can see, it's risky to discount tooth pain and “wait ‘til it goes away.” Our office can help you determine the origin of your pain and the best course of action to resolve it. When in doubt, it's always better to err on the side of caution!

If you would like more information about tooth pain and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Sensitive Teeth.”


By Drs. Jeff DiMariano & Shaina DiMariano
April 05, 2013
Category: Oral Health
Tags: celebrity smiles  
WhatOralApplianceDoesOlivaNewton-JohnUsetoProtectHerteeth

Though it's been a while since Olivia Newton-John sang her way into our hearts in the movie Grease, her smile is as radiant as ever. Today, Olivia is still singing, acting and busy with new ventures such as authoring a cookbook and raising money for the cancer center that bears her name in Melbourne, Australia. Whichever part of the world Olivia finds herself in, she protects that beautiful smile with an oral appliance that many find beneficial.

“I wear a nightguard to prevent wear on my teeth, custom-made by my dentist,” Olivia recently told Dear Doctor magazine. “I love it!”

Olivia's device, also referred to as a bite (occlusal) guard, is designed for people who clench or grind their teeth at night, or during stressful periods. Made of thin, wear-resistant plastic, it is custom-made to fit exactly over your top teeth. This allows the bottom teeth to slide gently across the top teeth without biting into them. Not only does this prevent excessive tooth wear, it also helps relax the muscles of the jaw.

Grinding or “bruxing,” as it's also called, can affect virtually any part of the oral system: the jaw joints or muscles, resulting in spasm and pain; the teeth themselves, resulting in wear, fractures or looseness; it can even cause an aching in the ears, head, neck or back.

If you are a teeth-grinder, you might not even know it unless a sleeping partner hears it or your dentist notices signs of wear. These habits are called “parafunctional” (para – outside, function – normal), meaning the biting forces it generates are well outside the normal range — sometimes as much as 10 times normal. So it's no wonder that damage to teeth can occur if they are not protected.

If you have any questions about grinding habits or nightguards, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Olivia Newton-John, please see “Olivia Newton-John.” Dear Doctor also has more on “Stress & Tooth Habits.”