My Blog
By Lee Oppenheimer, DDS, PA
May 29, 2020
Category: Dental Procedures
TreatingGumDiseasewithLasers

Since their development in the laboratory over five decades ago, lasers have found increasing use in our everyday lives. In the field of medicine, it’s not uncommon to find lasers in the offices of dermatologists, ophthalmologists and surgeons, to name just a few. Now, some dentists are finding that lasers can offer an alternative means of treating gum disease — and one that may have advantages in certain situations.

You probably know that a laser produces a special kind of light — in fact, its name is an acronym for “Light Amplification by Stimulated Emission of Radiation.” Essentially, a medical laser uses electrical energy to produce an intense and narrow beam of concentrated light. This light can be directed to a particular area, often via a fiber-optic channel. The laser’s precision allows a doctor or technician to focus the light energy exactly where it’s needed — to remove diseased tissue, seal off blood vessels, and sterilize a wound, for example.

For several years, periodontists — dentists who specialize in treating diseases of the gums — have been researching the use of lasers for treating certain types of gum disease. In standard clinical practice, hand-held instruments and ultrasonic cleaning tools are used at regular time intervals (3 – 6 months) to remove the sticky bacterial biofilm, as well as calculus (tartar), that forms in between teeth and gums. If that still isn't effective, gum surgery may be required to access the affected area, remove diseased tissue, and reduce pocket depth (the space below the gum line that gets larger as bone loss occurs) to prevent reinfection.

Recently, however, several new procedures have been developed that use lasers to accomplish some or all of these goals. One type of therapy uses a special laser that emits pulses of light with a specific wavelength (color) of 1064 nanometers. This light passes through healthy cells like a sunbeam through a window — but when it encounters darkly-pigmented bacteria, it vaporizes them instantly!

One of the potential advantages of laser treatment is its precision: focused directly on the area where trouble occurs, it targets diseased tissue but leaves healthy tissue alone. Another is that laser treatment is less invasive: It requires less tissue removal, and may cause less discomfort and tissue shrinkage (gum recession) than conventional periodontal surgery. And because it produces small amounts of heat, it can seal blood vessels and help control bleeding.

While lasers have long shown promise for treating gum disease, until recently it wasn’t clear if they offered any advantages over traditional methods. Now, several studies have shown that certain laser treatments can be just as effective as traditional gum surgery in many cases — with the potential benefit of being less invasive. In the future, the use of lasers for periodontal procedures is likely to increase.

It’s important to remember that no single treatment — not even a laser — can “zap” gum disease in one fell swoop. Controlling periodontal disease requires effective at-home oral hygiene combined with regular professional care. If you have questions about periodontal disease, please call our office to schedule a consultation.

By Lee Oppenheimer, DDS, PA
May 19, 2020
Category: Oral Health
Tags: loose teeth  
LoosePermanentTeethisaProblem-takeActionNow

If you've noticed one of your teeth feeling loose, you're right to believe it's not a good thing. Loose permanent teeth are a sign of an underlying problem.

Periodontal (gum) disease is usually the culprit. Caused by bacterial plaque, a thin film of food particles, gum disease causes the tissues that support teeth to weaken and detach. While a tooth can become loose from too much biting force (primary occlusal trauma), it's more likely bone loss from gum disease has caused so much damage that even the forces from normal biting can trigger looseness.

A loose tooth must be treated or you may lose it altogether. If it's from gum disease, your treatment will have two phases.

In the first phase we need to stop the gum infection by removing plaque and calculus (hardened plaque deposits). Hand instruments known as scalers or ultrasonic equipment are usually sufficient for removing plaque and calculus around or just below the gum line. If the plaque extends deeper near or around the roots, we may need to consider surgical techniques to access these deeper deposits.

Once the infection is under control and the tissues have healed, we can then undertake the second phase: reducing biting forces by breaking clenching and grinding habits, doing a bite adjustment for advanced problems and securing loose teeth with splinting.

Although there are different types of splinting — both temporary and permanent — they all link loose teeth to adjacent secure teeth much like pickets in a fence. One way is to bond dental material to the outer enamel of all the teeth involved; a more permanent technique is to cut a small channel extending across all the teeth and bond a rigid metal splint within it.

To reduce biting forces on loose teeth, we might recommend wearing a bite guard to keep the teeth from generating excessive biting forces with each other. We may also recommend orthodontics to create a better bite or reshape the teeth's biting surfaces by grinding away small selected portions of tooth material so they generate less force.

Using the right combination of methods we can repair loose teeth and make them more secure. But time is of the essence: the sooner we begin treatment for a loose tooth, the better the outcome.

If you would like more information on treating loose teeth, 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 “Treatment for Loose Teeth.”

By Lee Oppenheimer, DDS, PA
May 09, 2020
Category: Oral Health
NBAPlayersInjuryPointsOutNeedforMouthguards

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

By Lee Oppenheimer, DDS, PA
April 29, 2020
Category: Oral Health
Tags: gum recession  
4ThingsYouCanDotoAvoidDamageFromGumRecession

Gum recession is a serious oral condition in which the gums shrink back or “recede” from their normal position around the teeth. Because they're the primary protection for teeth below the enamel, this can expose the teeth to infection or cause painful sensitivity. And receded gums most certainly can diminish your smile.

But there are preventive measures you can adopt that might help you avoid this unpleasant condition. Here are 4 things you can do to minimize your risk for gum recession.

Practice daily oral hygiene. The main cause for recession is gum disease, a bacterial infection that weakens gum attachment to teeth. Gum disease usually arises from dental plaque, a thin bacterial film that builds up on teeth. Removing it every day with brushing and flossing minimizes the risk of gum disease and gum recession.

But don't overdo it. Although brushing is key to keeping your mouth healthy, too hard and too often can damage your gums and lead to recession. A little “elbow grease” may be appropriate for other cleaning tasks, but not your teeth—use gentle strokes and let the mild abrasives in your toothpaste do the main removal work. And avoid brushing more than twice a day.

See your dentist regularly. Your personal care efforts are a major part of preventing gum recession, but you can greatly increase the effect with professional dental care. That's because with even the best hygiene practice infections and other gum problems can still arise. You may also have inherited thinner gum tissues from your parents that increase your disease risk and bear closer monitoring.

Act quickly at the first signs of disease. Gum disease is a progressive disease, and it doesn't take long for it to become intrenched. The sooner it can be treated, the less likely you'll experience recession. So, make a dental appointment as soon as possible if you notice your gums are swollen, red or painful, or if they bleed easily after brushing.

There are ways to reverse gum recession. But many treatments like grafting surgery to regenerate new gum tissues can be quite involved and expensive. Following these tips can help you avoid gum recession altogether or stop it before it goes that far.

If you would like more information on how to avoid gum recession, 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 “Gum Recession: Getting Long in the Tooth.”

AvoidBecomingaDentalInjuryStatistic-GetaCustomMouthguardforYourYoungAthlete

Other than tooth decay, children don't encounter dental disease to the extent adults do. But injuries are another story: More than 5 million teeth are knocked loose each year, and a high percentage involve children. Roughly a third of these and similar children's injuries are sports-related.

April is National Facial Protection Month: Several oral and facial health organizations, including the American Association of Orthodontists, have joined together to raise awareness about the risks of injury to the face and mouth, especially among children. Many of these injuries have long-term consequences with lifetime treatment costs in the thousands of dollars.

But as the name implies, this awareness month is also about protection—what you can do to help your child avoid a costly and devastating dental injury. Top of the list: Have your child wear an athletic mouthguard during all contact sports activities (including practices).

The National Federation of State High School Associations mandates mouthguard wear for football, lacrosse, and ice and field hockey. But those aren't the only sporting activities where a mouthguard should be standard equipment: In fact, basketball has more orofacial injuries each year than any other sport. Generally, mouthguards should be worn for any sports activity that involves potential contact with other players or objects.

There is a variety of mouthguard choices, but most fall into two basic categories, “boil and bite” and custom-made. The former, readily available in retail sports stores, get their name from the procedure employed when first purchased to adjust their fit to an individual player. Out of the package, they should be soaked in hot or boiling water until softened, and then placed in the wearer's mouth to bite down on. After they cool, they'll retain that bite pattern.

Boil and bite guards are relatively inexpensive, but the fit isn't as precise as a mouthguard that is custom-made by a dentist. This can lead to comfort issues—and players are less likely to wear an uncomfortable mouthguard.

Custom mouthguards, on the other hand, have a more accurate fit, allowing them to be thinner and more comfortable. They also provide the highest level of protection against blows to the face and mouth. These are more costly than boil and bite guards, and younger athletes may need a replacement every few years to accommodate jaw growth development. But compared to the physical, emotional and financial cost of a dental injury, custom mouthguards are worth the investment.

A mouth or face injury can happen in an instant and result in damage that can have lingering effects for years. For the best protection, see that your star athlete has and wears a custom mouthguard.

If you would like more information about mouthguard protection, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”





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