DiMariano Family Dentistry Blog

Posts for: June, 2014

By Drs. Jeff DiMariano & Shaina DiMariano
June 25, 2014
Category: Dental Procedures
Tags: celebrity smiles   braces  
BracesARiteofPassageEvenforHollywoodKids

Her parents Will and Jada are Hollywood royalty, who helped her land her first acting role when she was 7. She released a hit single, “Whip My Hair,” before she had quite reached the age of 10; shortly afterward, she was signed to a record label. Yet the young singer and actress Willow Smith has at least one thing in common with plenty of ‘tweens and teens across America: She needed to wear braces to correct problems with the alignment of her teeth.

Why do braces seem to be a part of growing up for so many kids? One answer is because they work so well. Braces apply gentle pressure to the teeth through a thin, flexible wire called an archwire. Attached to the teeth with a metal or ceramic bracket, the archwire exerts a light force which causes teeth to gradually move into better positions. Sometimes, when additional force is needed, elastic bands or other appliances may be used in conjunction with braces.

Most everyone is familiar with the silvery metal “tracks” of traditional braces. But did you know that there are a number of other options too? For a more inconspicuous look, you may be able to have braces with tooth-colored ceramic brackets; then, only the thin archwire will be visible in your mouth. It’s even possible in some cases to place the metal wires and brackets on the tongue side of the teeth. With this system, called lingual braces, the orthodontic hardware is truly invisible.

What if you didn’t need metal braces at all? Some people can get good results using a system of clear plastic aligners instead of braces. The aligners are worn 23 hours a day, but can be taken off for cleaning and for important events. They work best for correcting mild or moderate alignment problems.

Still, plenty of people feel that if they’re going to wear braces, they might as well flaunt them. That’s why some types of braces are available with bands that come in different colors. When Willow’s brother Jayden wore braces, he was reported to favor red and black ones. Jayden, who is about two years older than his sister, had his braces removed just before Willow got hers put on.

So if it turns out that you need braces, remember that lots of your favorite celebrities wore them too. And keep in mind that, depending on your own situation, you may have several options to choose from.

If you would like more information about braces or orthodontic treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics for the Older Adult.”


By Drs. Jeff DiMariano & Shaina DiMariano
June 17, 2014
Category: Dental Procedures
DidYouKnowClearAlignersHaveBeenImprovedForTeens

Metal braces are often considered a rite of passage for teenagers whose teeth need straightening. While some teens have no problem with this, others are more self-conscious and would like a less noticeable and less restrictive form of orthodontic treatment (“ortho” – to straighten; “odont” – teeth). After all, traditional braces can sometimes require diet modification, regular tightenings can cause discomfort, and the hardware itself can irritate the inside of the mouth. All of these things can limit a teen's ability to function normally during an already difficult stage of life.

That's why many teens today are opting for removable clear aligners, which have been popular with adults for years. In this system of orthodontic treatment, transparent, flexible, plastic “trays” are custom-made to move an individual's teeth into better alignment in a step-by-step fashion. Each tray moves the teeth a little bit further, according to a precise plan developed with specialized computer software by an orthodontist, or a general dentist who has received special training. It's not available from every dentist, but we are happy to be able to offer it here.

It used to be that clear aligners were not recommended for teens for two main reasons. For one thing, because they are removable rather than attached to the teeth, it was assumed a teenager would not be as conscientious as an adult about wearing them nearly 24 hours a day, which is necessary to achieve the desired results. Now, however, clear aligners for teens have colored “compliance indicators” that fade over time. With this new tool, dentists and parents — and teens themselves — can monitor compliance and progress.

The other main problem in prescribing clear aligners for teens had been that their second molars are still growing into position. This problem, too, has been solved. Clear aligners now have “eruption tabs” that serve as space-holders for teeth that have yet to grow in.

Finally, in recent years, improvements have been made to the whole clear aligner system that allow it to be used for more serious malocclusions (bad bites). So it's actually a viable option for more orthodontic patients in general — teens as well as adults.

If you would like to learn more about clear aligners for your teenager, please contact us or schedule an appointment for a consultation. You can also find out more in the Dear Doctor magazine article “Clear Aligners For Teenagers.”


By Drs. Jeff DiMariano & Shaina DiMariano
June 09, 2014
Category: Oral Health
Tags: oral health   x-rays  
ConeBeamCTBringsThree-DimensionalViewstoX-RayImaging

There’s no question that x-ray imaging has transformed how we diagnose and treat dental problems. But traditional x-rays have at least one limitation — they are two-dimensional portraits that can only provide a portion of the information available. If you could view the interior of teeth or other mouth structures in three dimensions, you would have access to more detail about their conditions.

Computerized axial tomography (CAT) scanning has brought that third dimensional view to physicians generally and, in more recent years, to dentists. The latest development in this technology is known as Cone Beam Computed Tomography (CBCT). A CBCT emits a spiral of x-rays that form a cone-shaped beam that is caught on detectors. Using digital geometry, the CBCT then generates a three-dimensional image by precisely “layering” this large series of two-dimensional images caught by the detectors on top of each other.

CBCT is already making a significant impact in dentistry and its related specialties. Dentists now can visualize with amazingly precise detail the three-dimensional anatomy of the teeth, jaws, facial bone and other structures in the head and neck area. Orthodontists can examine the growth stages of a patient’s teeth eruption to better prepare treatment strategies. Oral surgeons can determine the precise location of impacted teeth and their exact proximity to nerves and sinuses. And, periodontists who specialize in gum disease and treatment can better determine the level of bone loss and gum attachment for more accurate diagnoses and effective treatment.

While a CBCT delivers a higher dose of x-rays than a traditional panoramic radiograph, it actually delivers a lower dosage than a digital standard 18 film full mouth series or than conventional medical CT scanners. The field of view also determines the level of x-ray exposure — the smaller the field of view (and more concentrated the x-rays) the higher the dosage and the better detail of anatomy.

The good news, though, is that a low dosage CBCT scan can still provide a level of detail that can provide dentists with a very accurate view of anatomical features, including bone density and mass, in three dimensions. That capability can vastly elevate the accuracy of diagnoses and lay the groundwork for effective dental treatment.

If you would like more information on the uses of CBCT scanning to help you maintain dental health, 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 “CAT Scans in Dentistry.”


By Drs. Jeff DiMariano & Shaina DiMariano
June 06, 2014
Category: Oral Health
Tags: medication   aspirin  
BeSureYourDentistKnowsYoureUndergoingAspirinTherapy

Acetylsalicylic acid (ASA), better known as aspirin, is an effective pain reliever and fever reducer. More recently, its anti-inflammatory properties have become part of the management of cardiovascular disease. But while regular use may benefit your general health, it could complicate your dental care.

Aspirin helps reduce inflammatory pain or fever by blocking the body’s formation of prostaglandins, chemicals that contribute to inflammation after trauma or injury. It also prevents blood platelets from sticking and clumping together. While this can prolong normal bleeding and bruising, it also helps the blood move freely through narrowed or damaged blood vessels, which reduces the risk of heart attack or stroke in at-risk cardiovascular patients. Due to side effects from prolonged aspirin use like kidney damage, stomach bleeding, or ulceration, physicians normally prescribe a low aspirin dosage (81 milligrams) to minimize these effects.

Because of its effect on bleeding and clotting, it’s important that every member of your healthcare team — including your dentist — knows how much and how often you take aspirin. The change it causes in your body’s clotting mechanism may also affect how dental procedures are carried out; by knowing you take aspirin regularly we can take extra precautions to ensure your safety.

In fact, if you’ve been prescribed aspirin for a heart condition, you may be tempted to stop taking it before a dental procedure out of fear of profuse bleeding. This is highly unadvisable — the sudden discontinuation could increase your risk of heart attack, stroke or even death. You should only discontinue aspirin treatment at the direction of your prescribing physician.

Another aspirin-related effect may involve your gums and other soft tissues. You may notice gum tissue bleeding after brushing or flossing; while this is normally a sign of periodontal gum disease, it could also be the result of your aspirin therapy. The only way to know for sure is to schedule a visit with us to examine your gums.

When it comes to aspirin or other blood-related therapies, the key is to communicate your health status with us, including all medications you are taking. With that knowledge we can provide you with the most informed and safest dental care we can.

If you would like more information on the effects of aspirin on your dental care, 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 “Aspirin: Friend or Foe?