DiMariano Family Dentistry Blog

Posts for: February, 2014

By Drs. Jeff DiMariano & Shaina DiMariano
February 24, 2014
Category: Oral Health
GiulianaandBillRancicTalkToothDecay

For some kids, having a cavity or two is just part of growing up. Not for Giuliana Rancic. When she was a child, the TV personality didn't have a single cavity — and she still doesn't. But for her husband Bill, co-star of the Style Network reality show Giuliana and Bill, it was a different story. A cavity-prone kid, he was never certain what a visit to the dentist might hold in store. “I can still remember the anticipation,” he recently told Dear Doctor magazine. “I always hoped I would get out of the checkups without a cavity!”

Why do some people get more cavities than others? There are a number of factors at work, but to understand it better, let's look at how tooth decay occurs.

How Cavities Form
Cavities — also called dental caries — are small pits or holes in the teeth that are caused by tooth decay. Tooth decay itself is a chronic disease that can flare up when plaque isn't kept under control. A thin, bacteria-laden film, plaque sticks to tooth surfaces both above and below the gum line, and can build up in the absence of effective oral hygiene.

Of course, everyone has bacteria in their mouth, both “good” and “bad” (pathogenic) types. But when the bad guys outnumber the good, trouble can start. When you consume sweets, plaque bacteria process the sugars and release acid as a byproduct. The acid eats into tooth surfaces, causing decay — and cavities that need filling. Left untreated, decay can work its way into the tooth's pulp, resulting in infection and pain. Eventually, treatment might involve a root canal — or, in the worst case, extraction.

What can you do if you seem to be prone to cavities? One effective way to fight tooth decay is by maintaining good oral hygiene. Brush at least twice daily, for at least two minutes each time. Use a soft-bristled brush and a dab of fluoride toothpaste to clean all around your teeth. Most importantly, floss above and below the gum line, every day. And just as important, don't forget to have regular dental checkups every six months.

A Healthy Balance
Another cavity-fighting strategy is eating a balanced diet. Avoid soda, sugary “energy” drinks and sweet treats — but if you choose to consume sugar, have it with meals instead of between meals. This will give your saliva, which has natural cavity-fighting properties, a chance to work.

“It's all about maintaining a healthy balance,” Giuliana told Dear Doctor. And Bill agrees: “I love nuts and fruit for a healthy snack,” he said, adding that he's meticulous about brushing and flossing. And when the couple smiles, you can see how those healthy habits pay off.

If you would like more information on preventing tooth decay, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Tooth Decay” and “Tooth Decay – How To Assess Your Risk.”


By Drs. Jeff DiMariano & Shaina DiMariano
February 21, 2014
Category: Dental Procedures
ImplantOverdenturesaMarriageofOptionsforLowerJawToothReplacement

For well over a century, removable dentures have been the main treatment option for patients suffering from severe or total edentulism (loss of teeth). In recent years, however, the dental implant has been recognized as the best option because it can provide patients with permanent tooth replacement, and even more so as implant technology continues to advance.

But while permanent tooth replacement using implants offer more comfort and a better fit than dentures, they are more expensive, sometimes out of the financial reach of many patients. There is, however, one alternative for the lower jaw that blends the two options for tooth replacement into one. This alternative is known as an implant overdenture.

The implant overdenture begins just as a fixed dental implant would: we surgically implant two titanium posts into the lower jaw and allow them to fuse with the bone over time (thanks to the unique way that bone interacts with titanium). But rather than next affixing a porcelain crown to the post as we would with a dental implant, we would instead fashion a denture that fits over the two posts (hence the term overdenture). The overdenture has receiver sites that connect securely with the titanium posts to hold the overdenture in place. This ensures a snug fit with no slippage — resulting in better ability for the wearer to chew food and speak — and without the continuous need for dental adhesive. And just as with traditional dentures, you can remove the overdenture for cleaning.

It might also be an optimal solution for patients with severe issues involving bone loss or compromised teeth that make it difficult for them to support either a fixed prosthesis or a traditional removable denture.

This option does have some drawbacks: since it's still a removable denture, it can still move during meals and food can sometimes get underneath it, which can be annoying. Also, overdentures for the upper jaw require more than two implants because the upper bone is less dense; thus because of a greater number of implants, an upper overdenture is more costly than a lower one.

In the end, an implant overdenture to the lower jaw might be an optimal solution for you — financially and practically — to restore function from severe or total edentulism.

If you would like more information on implant overdentures, 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 Overdentures for the Lower Jaw.”


By Drs. Jeff DiMariano & Shaina DiMariano
February 13, 2014
Category: Oral Health
Tags: oral health  
PreservingYourTeethsEnamelCouldPreserveYourTeeth

Teeth are composed of layers of different types of tissue. The main inner layers — the pulp and dentin — help the teeth respond and adapt to external forces. But they’re vulnerable to decay and quite sensitive to environmental extremes. They are protected from all these by a coating of enamel, made of the hardest material found in the human body.

But while enamel is strong, it’s not invincible — it can soften and dissolve (de-mineralize) if the mouth environment becomes too acidic. While de-mineralization occurs normally whenever the mouth becomes too acidic after eating or drinking, saliva helps neutralize the acid (buffering); in fact, saliva can restore to the enamel some of the calcium and other minerals it has lost (a process called re-mineralization).

If the acidic level remains too high for too long it can overwhelm saliva’s buffering ability and cause permanent mineral loss to the enamel. This erosion leaves teeth more susceptible to decay and disease and could lead to tooth loss. With this in mind, here’s some ways you can help preserve your enamel:

  • Wait about thirty to sixty minutes after eating or drinking to brush your teeth. Counterintuitive as this may sound, it takes about thirty minutes for saliva to restore a normal pH level and re-mineralize the enamel. If you brush within this window of time, you could brush away some of the softened minerals from the enamel.
  • Only brush twice a day. Over-brushing causes undue enamel wear, as well as contributing to receding gums.
  • Take advantage of less acidic or mineral-rich beverages. Drink milk or water most of the time, rather than juices, sodas or sports drinks. The calcium in milk or as an additive to acidic beverages aids in buffering and re-mineralization.
  • Use a straw for acidic beverages. With a straw your teeth avoid direct contact with most of the beverage’s acid, a key factor in de-mineralization.
  • Avoid eating just before bed. Saliva flow decreases significantly when we sleep. If you eat right before bed, there may be less saliva available for buffering and re-mineralization.

Following these tips, along with effective oral hygiene, will go a long way in protecting your teeth’s enamel coating — and preserving your teeth in the long run.

If you would like more information on enamel erosion and how to prevent 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 article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”


By Drs. Jeff DiMariano & Shaina DiMariano
February 05, 2014
Category: Oral Health
LocalAnesthesiaHelpsDecreaseDiscomfortandAnxietyDuringTreatment

Local anesthesia has emerged over the last half century as one of the most effective tools in dentistry. Its use has literally revolutionized pain control and led to a new description of care known as comfortable dentistry.

The term “local” indicates that the numbing agent is applied only to the area affected by the procedure to temporarily block nerve sensation while the patient remains conscious. Some topical anesthetics are applied to the surface of the lining tissues of the mouth with a cotton swab, adhesive patch or spray to immediately numb the area. While topical anesthetics are sometimes used to increase comfort during teeth cleaning, they’re most often used to block the feeling of the needle prick of an injectable “local” anesthetic. Injectable “local” anesthetics provide a deeper numbing of the teeth, gums and bones.

Along with other calming or sedative techniques, local anesthesia is especially helpful in lowering a patient’s anxiety and stress levels during treatment. It’s a necessity during treatments like decay removal, deep root cleaning, fillings, tooth extractions or gum surgery because the nerve-rich tissues of the mouth are especially sensitive to pain. There are some treatments, however, that don’t call for anesthesia such as enamel removal or shaping (unless the more sensitive dentin below the enamel layers has been exposed).

One common complaint about local anesthesia is the lingering numbness a patient may continue to feel even a few hours after their visit. This inconvenience can be reduced by using different types of anesthetics, and there are now agents that can be applied after a procedure to reverse the effects of an anesthetic.

Local anesthesia benefits both you the patient and your dental professional — you’re more comfortable and less stressful during your visit, and your dentist or hygienist can work more effectively knowing you’re at ease. A pain-free, anxiety-free treatment atmosphere contributes greatly to your long-term dental health.

If you would like more information on the use and benefits of local anesthesia for dental procedures, 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 “Local Anesthesia for Pain-Free Dentistry.”