DiMariano Family Dentistry Blog

Posts for: April, 2015

By Drs. Jeff DiMariano & Shaina DiMariano
April 22, 2015
Category: Dental Procedures
CherylColesSee-ThroughBraces

What if you had orthodontic treatments to enhance your smile — and nobody knew about it until it was all done?

That (almost) happened to British singer, cover girl and television personality Cheryl Cole. Since her big break in 2002, on the British reality show Popstars: The Rivals, Cole has had a successful music career, taken turns judging both the British and American versions of The X Factor, and graced the covers of fashion magazines like Elle and Harpers Bazaar.

And somewhere along the way, Cole wore an orthodontic appliance. It very nearly went undetected… until a colleague spilled the beans. That’s when Cole was forced to divulge her secret: For a period of time, she had been wearing clear aligners on her teeth. Until her frenemy’s revelation, only a few people knew — but when you compare the before-and-after pictures, the difference in her smile is clear.

So what exactly are clear aligners? Essentially, they consist of a series of thin plastic trays that are worn over the teeth for 22 hours each day. The trays are custom-made from a computerized model of an individual’s mouth. Each tray is designed to move the teeth a small amount, and each is worn for two weeks before moving on to the next in the series. When the whole series is complete, the teeth will have shifted into their new (and better aligned) positions.

Besides being virtually unnoticeable, aligners are easy to remove. This makes it easy to keep the teeth clean — and can come in handy for important occasions (like cover-photo shoots and acceptance speeches). But don’t remove them too frequently, or they won’t work as planned. If that’s a possibility (with teens, for example), aligners are available with “compliance indicators” to ensure they’re being worn as often as they should be. They can also be made with special tabs to hold a place for teeth that haven’t fully erupted (come in) yet — another feature that’s handy for teens.

So if you need orthodontic work but prefer to stay “under the radar,” ask us whether clear aligners could be right for you. Cheryl Cole did… and the results gave her something more to smile about.

If you would like more information on clear aligners, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Clear Aligners for Teenagers.”


By Drs. Jeff DiMariano & Shaina DiMariano
April 14, 2015
Category: Oral Health
Tags: oral health   oral hygiene  
OvercomingDentalCareObstaclesinChildrenWithChronicDiseases

All children encounter sickness as they grow; thankfully most of these conditions are relatively mild and fade away in short order. But some children endure more serious, longer lasting conditions. The health of children with chronic diseases can be impacted in numerous ways, including the health of their teeth and gums.

Unfortunately, dental care is often pushed to the side as caregivers understandably focus on the primary disease. In addition, many chronic conditions involving behavior, such as autism, attention deficit and hyperactivity disorder (ADHD) or intellectual disabilities, may inhibit the child’s ability to cooperate with or even perform daily oral hygiene. Many special needs children have an acute gag reflex that makes toleration of toothpaste, spitting matter from the mouth, or keeping their mouths open more difficult. However difficult it may be, though, it’s still important to establish daily hygiene habits to reduce the risk of tooth decay and gum disease.

There are techniques for building a daily routine for children with physical and behavioral limitations. For example, using “modeling and shaping” behavior, you (or perhaps a sibling) brush your teeth with your child to demonstrate how it should be done. If there’s a problem with cooperation, you can also position the child “knee to knee” with you as you brush their teeth. In this way you’ll be able to meet their eyes at a level position and lessen the chance of a confrontation.

We encourage all children to have their first dental visit before their first birthday. This is especially true for children with chronic conditions. The Age One visit helps establish a benchmark for long-term care; it then becomes more likely with regular visits to discover and promptly treat dental disease. This is especially important for special needs children who may have congenital and developmental dental problems, like enamel hypoplasia, a condition where the teeth have not developed sufficient amounts of enamel.

Teeth are just as much at risk, if not more so, in children with chronic diseases. Establishing daily hygiene and regular checkups can reduce that risk and alleviate concern for their long-term oral health.

If you would like more information on oral healthcare for children with chronic diseases, 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 “Managing Tooth Decay in Children With Chronic Diseases.”


By Drs. Jeff DiMariano & Shaina DiMariano
April 06, 2015
Category: Oral Health
EatingDisordersMayContributetoDamagedTeethandGums

While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.

Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.

It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.

Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.

Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.

The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.

If you would like more information on the effect of eating disorders on oral 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 “Bulimia, Anorexia & Oral Health.”


By Drs. Jeff DiMariano & Shaina DiMariano
April 03, 2015
Category: Dental Procedures
Tags: dentures  
NewPartialDenturesMoreComfortableandDurableThanOlderModels

While dental implants are the preferable choice for teeth replacement, your life circumstances may cause you to postpone it or some other permanent restoration. In the meantime, you need a temporary solution for your tooth loss.

Removable partial dentures (RPDs) have met this need for many years. RPDs are traditionally made of rigid, acrylic plastic resin and fasten to existing teeth with metal clasps. While effective as temporary tooth replacements, RPDs do have their drawbacks: they can be uncomfortable, develop a loose fit and are prone to wear and staining.

Recently, though, new RPDs made of a flexible type of nylon are addressing some of these drawbacks. Because the nylon material is thermoplastic (able to change shape under high heat), it can be injected into a cast mold of a patient’s mouth to create the denture base, to which life-like replacement teeth are then attached. And rather than a metal clasp, these RPDs have thin, finger-like nylon extensions that fit snugly around existing teeth at the gum line.

The new RPDs are lightweight, resistant to fracture and offer a more comfortable, snugger fit than the older RPD. And because the nylon material can be made to closely resemble gum tissue, the base can be designed to cover receding gum tissue, which may further improve the appearance of a patient’s smile.

On the downside, these new RPDs are difficult to reline or repair if they’re damaged or the fit becomes loose. And like all RPDs, they must be regularly removed and cleaned thoroughly to prevent any accumulating bacterial biofilm that could increase the risk of gum disease or tooth decay (the attachment extensions are especially susceptible to this accumulation). They should also be removed at night, since the reduction in saliva flow while you sleep can worsen bacterial buildup.

Still, the new flexible RPD is a good choice to bridge the time gap between lost teeth and a permanent restoration. They can restore lost function and improve your smile during the transition to implants or a fixed bridge.

If you would like more information on temporary tooth replacement, please contact us or schedule an appointment for a consultation.