DiMariano Family Dentistry Blog

Posts for: September, 2013

By Drs. Jeff DiMariano & Shaina DiMariano
September 25, 2013
Category: Oral Health
Tags: toothache  
IdentifyingtheSourceofMouthPainLeadstoMoreEfficientTreatment

You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.

This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.

We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.

Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.

The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.

Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.

If you would like more information on the various causes of tooth pain, 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 “Confusing Tooth Pain.”


By Drs. Jeff DiMariano & Shaina DiMariano
September 17, 2013
Category: Dental Procedures
BoneGraftingforDentalImplants

Dental implants are a great choice for many people who need to permanently replace a missing tooth. Reliable and long-lasting, they offer a highly successful outcome, and can even help reduce long-term bone loss and damage to adjacent teeth. One of the best features of implants is that the titanium metal of which they're made actually becomes fused with your natural, living bone tissue.

But sometimes, an examination may show that where you have missing teeth, you may not have enough bone remaining to properly place an implant. Does this mean you're out of luck? Not necessarily!

Employing the refined techniques of bone grafting, regenerating bone tissue has become a standard procedure in periodontal and oral surgery. In many cases, it's possible to build up just the right amount of bone using a variety of grafting materials, in combination with other special techniques. This can enable patients who wouldn't otherwise be good candidates to enjoy the benefits of dental implants.

How does it work? Basically, by helping your body repair itself.

You may already know that bone is a living tissue, which can respond to its environment positively (by growing) or negatively (by resorbing or shrinking). When you've lost bone tissue, the trick is to get your body to grow more exactly where you want it. Once we know where — and how much — replacement bone is needed, we can place the proper amount of bone grafting material in that location. Then, in most cases, the body will use that material as a scaffold to regenerate its own bone.

Bone grafting is often done at the time of tooth removal as a preventive procedure or prior to the placement of an implant, to give the body time to re-grow enough of its own tissue. The procedure is generally carried out under local anesthesia, or with the aid of conscious sedation. Sometimes, if there is enough natural bone to stabilize it, it's even possible to place an implant and perform a bone graft at the same time.

So if you're considering dental implants, let us advise you on what's best for your particular situation. We have the knowledge and experience to help you make the right choices, and achieve the most successful outcome.

If you would like more information about bone grafting, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Can Dentists Rebuild Bone?


By Drs. Jeff DiMariano & Shaina DiMariano
September 09, 2013
Category: Dental Procedures
RealityStarKeptHisEyesonthePrizeNewTeeth

If you follow the hit TV reality show Amazing Race, you know that professional-hockey-playing brothers Bates and Anthony Battaglia won the $1 million prize in the latest globe-spanning competition. You may also have witnessed Anthony removing his false front teeth from time to time — like when he had to dive for pearls in Bora Bora. Since he plans to resume his sports career, Anthony wears a partial denture to fill the gap in his classic “hockey mouth.” He has said that when he finally hangs up his skates, he will use some of his Amazing Race prize money to get new, permanent teeth. When it's time to get that new smile, Anthony, like many people, will have to choose between two good options for permanent tooth replacement.

The preferred option for most people is dental implants. In this system, tiny titanium posts substitute for the root part of your missing tooth (or teeth). These are placed beneath your gum line in a minor surgical procedure we perform right here at the dental office. The amazing thing about dental implants is that they actually fuse to your jawbone, allowing your replacement teeth to last a lifetime.

The titanium implant itself is not visible in the mouth; the part of an implant tooth that you see is the lifelike crown. Virtually indistinguishable from your natural teeth, the crown is attached to the implant above the gum line. Dental implants can be used to replace a single tooth, multiple teeth, or even all your teeth. You don't necessarily need one implant for every tooth because implants can support bridgework or even a complete set of prosthetic teeth.

The second-best option is a natural-tooth fixed bridge. In this system, we use healthy natural teeth on either side of the empty space left by a missing tooth (or teeth) as supports for one or more of the prosthetic teeth that will fill the gap. The downside is that in order to turn these healthy teeth into supports (which are referred to in dentistry as “abutments”), we need to remove some enamel and then cap them. This procedure can leave those teeth more prone to decay than they were before. But with regular dental exams and good oral hygiene on your part, bridgework can last many years.

Which system is right for you? That's a question we would be happy to help you determine... even if you haven't won a large jackpot or gone pearl diving in Bora Bora. If you've been looking forward to the day when you can have permanent replacement teeth, why wait? Contact us or schedule an appointment for a consultation. We will help you find your ideal solution to the problem of missing teeth! For more information, please see the Dear Doctor magazine articles “Dental Implants vs. Bridgework” and “Dental Implants: Your Third Set of Teeth.”


By Drs. Jeff DiMariano & Shaina DiMariano
September 06, 2013
Category: Oral Health
Tags: oral health   oral hygiene  
FiveGuidelinesforImprovingYourYoungstersOralHealth

Young children are like sponges, soaking up patterns of behavior they will later apply in many circumstances throughout life. In this learning process, they often look to family members for guidance. Some good habits, like saying “please” and “thank you,” can be taught verbally. Others are best learned by example.

Developing good habits early will benefit your children for a lifetime — especially where their health is concerned. Fortunately, it isn't hard to instill good oral hygiene behavior in a young child; for example, most all children are successfully taught to brush their teeth at an early age. What follows are some tips that might not be as obvious, but will help your children build healthy routines for maintaining optimum oral hygiene.

1) Teach your children how to check the cleanliness of their own teeth.

How? By running their tongue over the tooth surfaces! If the teeth feel nice and smooth, they're likely to be clean, too. Remember to give kids a soft brush, and tell them to use gentle strokes in brushing.

2) Avoid transferring your own oral bacteria to your children.

Children aren't born with decay-producing bacteria — they get them from others! That's why sharing baby's spoon or licking a pacifier clean aren't really good ideas. (Neither is pre-chewing a baby's food, despite what some birds and celebrities do. Trust us on this.)

3) Set an example of healthy eating habits for your children.

Follow common-sense guidelines (like those in www.choosemyplate.gov) for maintaining a balanced diet, eating plenty of vegetables and whole grains, drinking lots of water and getting moderate exercise.

4) Limit sugary treats to mealtimes, not snack times — if you allow them at all.

Oral bacteria utilize sugar for energy and when they metabolize it, they produce harmful acids. These acids attack the teeth and cause decay. The more sugar, the higher potential for stronger acids. Saliva helps neutralize these acids — but not if sugar is constantly present in the mouth. Try to limit sugary treats to mealtimes, and serve a healthier snack between meals.

5) Encourage your children to stop sucking thumbs and pacifiers by age 3.

Thumb sucking is a normal, comforting habit that may begin in the womb. Most kids stop on their own between ages 2 and 4. But long-term sucking on fingers or a pacifier can lead to tooth and jaw-development problems. We can help you find ways to gently encourage children to stop when it's time.

If you would like more information about instilling good oral hygiene habits in children, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”