DiMariano Family Dentistry Blog

Posts for: January, 2019

By Drs. Jeff DiMariano & Shaina DiMariano
January 25, 2019
Category: Oral Health
Tags: medicine  
NSAIDsCouldbeJustasEffectiveasNarcoticsManagingDentalPain

Like other healthcare providers, dentists have relied for decades on the strong pain relief of opioid (narcotic) drugs for patients after dental work. As late as 2012, doctors and dentists wrote over 250 million prescriptions for these drugs. Since then, though, those numbers have shrunk drastically.

That’s because while effective, drugs like morphine, oxycodone or fentanyl are highly addictive. While those trapped in a narcotic addiction can obtain drugs like heroine illicitly, a high number come from prescriptions that have been issued too liberally. This and other factors have helped contribute to a nationwide epidemic of opioid addiction involving an estimated 2 million Americans and thousands of deaths each year.

Because three-quarters of opioid abusers began their addiction with prescription pain medication, there’s been a great deal of re-thinking about how we manage post-procedural pain, especially in dentistry. As a result, we’re seeing a shift to a different strategy: using a combination of non-steroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen and acetaminophen, instead of a prescribed narcotic.

These over-the-counter drugs are safer and less costly; more importantly, though, they don’t have the high addictive quality of an opioid drug. A 2013 study published in the Journal of the American Dental Association (JADA) showed that when two NSAIDs were used together, the pain relief was greater than either drug used individually, and better than some opioid medications.

That’s not to say dentists no longer prescribe opioids for pain management following dental work. But the growing consensus among dental providers is to rely on the double NSAID approach as their first-line therapy. If a patient has other medical conditions or the NSAIDs prove ineffective, then the dentist can prescribe an opioid instead.

There’s often hesitancy among dental patients on going this new route rather than the tried and true opioid prescription. That’s why it’s important to discuss the matter with your dentist before any procedure to see which way is best for you. Just like you, your dentist wants your treatment experience to be as pain-free as possible, in the safest manner possible.

If you would like more information on how dentists are safely managing pain in dental care, please contact us or schedule an appointment for a consultation.


By Drs. Jeff DiMariano & Shaina DiMariano
January 15, 2019
Category: Oral Health
Tags: fluoride  
ModerateFluorideUsePackstheBiggestPunchforDecayPrevention

In the battle against tooth decay, fluoride is an important weapon. Since the discovery of its dental health benefits a century ago, fluoride has been credited with saving countless teeth.

But over its history in dental care, this natural-occurring chemical has also had its share of controversy with concerns raised from time to time on potential health dangers. These run the gamut from “conspiracy theory” speculations to credible research like a 2006 National Research Council study that suggested a possible increased risk of bone fracture or cancer from over-consumption of fluoride.

Even so, there is actually little evidence or even record of incidence for such dire consequences. The only definitive health effect from fluoride found after decades of copious research is a condition called fluorosis, a permanent staining effect on the teeth. Fluorosis poses a cosmetic problem but does not harm the health of the teeth.

Moderation in fluoride use seems to be the key to gaining its health benefits while avoiding fluorosis. One influential fluoride researcher, Dr. Steven Levy, estimates 0.05-0.07 milligrams of fluoride per one kilogram of body weight (about a tenth the weight of a grain of salt for every two pounds) is sufficient to gain the optimum dental benefit from fluoride.

The real question then is whether your family’s current consumption of fluoride is within this range. That will depend on a number of factors, including whether your local water utility adds fluoride to your drinking water supply and how much. You may also be ingesting fluoride through processed foods, juices and even some bottled waters. And you can encounter fluoride in dental care including toothpastes and clinical treatments.

One way to moderate your family’s fluoride intake is to be sure all your family members are using the correct amount of fluoride toothpaste for their age while brushing. Infants need only a slight smear on the end of the brush, while older children can brush adequately with just a pea-sized amount. For other tips and advice, talk to your dentist about your family’s fluoride intake and how you might adjust it.

Even with the possibility of fluorosis, fluoride still provides an incredible benefit in preventing tooth decay. By understanding fluoride and keeping your intake within normal ranges you can maximize its benefit for healthier teeth and minimize the fluorosis risk.

If you would like more information on the role of fluoride in 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 “Fluoride & Fluoridation in Dentistry.”


By Drs. Jeff DiMariano & Shaina DiMariano
January 05, 2019
Category: Oral Health
Tags: oral hygiene  
4WaystoCheckonYourBrushingandFlossingEffectiveness

For most of us, brushing and flossing is a routine part of daily life. But has it become such a routine that you may not be getting the most out of your daily regimen?

First, let's be clear about what you're trying to accomplish with these two important hygiene tasks, which is to remove as much accumulated dental plaque as possible. This thin film of bacteria and food particles is the primary cause for both tooth decay and periodontal (gum) disease.

So how can you tell if you're effectively cleaning dental plaque from your teeth? Here are 4 ways to check your brushing and flossing skills.

The tongue test. Move your tongue across the surface of your teeth, especially at the gum line, immediately after brushing and flossing. "Plaque-free" teeth will feel smooth and slick. If you feel any grittiness, though, you may be missing some plaque.

Floss check. For a similar effect after your daily hygiene take a fresh piece of floss and run it up and down your teeth. If the teeth are clean and you are using un-waxed floss, the floss should "squeak" as you move it up and down.

Disclosing agents. You can also occasionally use a plaque disclosing agent. This product contains a solution you apply to your teeth after brushing and flossing that will dye any leftover plaque a specific color. Disclosing agents are handy for uncovering specific areas that require more of your future hygiene attention. ¬†And don't worry—the dye is temporary and will fade quickly.

Dental visits. For the ultimate test, visit your dentist at least twice a year. Not only can dental cleanings remove hard to reach plaque and calculus (hardened tartar), but your dentist or hygienist can evaluate how well you've been doing. Consider it your "final exam" for oral hygiene!

Be sure to also ask your dental provider for tips and training in better brushing and flossing. Becoming more effective at these critical tasks helps ensure you're keeping your teeth and gums free of disease.

If you would like more information on best oral hygiene practices, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”