A Brighter Smile For The New Year

It's amazing how times flies.  This year is almost over and it seems like it just got started.  Chanukah has passed and Christmas and the New Year are around the corner.  Do you think it's too late to bring in the new year with a whiter, brighter smile?  It's not!

If you opt for take home whitening, if you get started right away, you will have a beautiful whiter smile by New Year's Eve.  Take home whitening can be accomplished in several ways.  For younger people, whitening kits that can be purchased at the pharmacy, can usually whiten a smile satisfactorily. However, for most adults, professional whitening is needed to see a favorable result.

Professional whitening is usually accomplished in 1 - 2 weeks.  We take impressions of your teeth and from a model of your teeth that is made from the impression, we make plastic trays that fit exactly over your teeth.  With a custom fitted tray, just the right amount of whitening agent can be placed in the tray, and the whitening agent works directly on your tooth surface.  Most people start seeing an improvement in their smile in a few days, and by 10 days to two weeks, most people are happy with the whitening.

Research shows that whitening that takes place over time is the best whitening, and the results last the longest.  It may take up to 18 months before you may want a touch up.  Save your custom trays, and then all you have to do is purchase some more whitening agent, and you can whiten your teeth again.

There is a faster method for whitening your teeth called one-hour whitening.  This kind of whitening takes place in the dental office.  There is an advantage to getting a quick result, but this procedure costs more than take home whitening, uses stronger whitening agents, and requires that you sit perfectly still for an hour.  The results are not always as white as some people may like, and one-hour whitening results don't last as long as take home whitening results.  If you don't have time to wait for a take home result before a big party or upcoming event, one-hour whitening can be a "life saver" that enables you to smile with confidence and enjoy having party photos.

Whether you whiten your teeth to bring in the new year, or not, we wish you only blessings and always something to smile about.  Let us know if we can help you smile more confidently.  You can always call for a free cosmetic evaluation at 973-761-5090.  For information about whiter teeth and other dental topics visit www.DrTav.com.

Happy Holidays to all!

What Everybody Ought To Know About Porcelain Veneers

If you are unhappy with your smile for any number of reasons, you have got to know about porcelain veneers.  In two visits you can have the smile of your dreams and in most cases you may not even need any novocaine to accomplish this.  

What are porcelain veneers and how do they accomplish creating a Hollywood smile or smile makeover?  Porcelain veneers are eggshell thin pieces of porcelain that are bonded onto the outer surface of your teeth to resurface your teeth.  They can change the color, change the shape, change the size, fill in gaps, "straighten" tooth rotations, and do all of this while providing a surface that's smoother than your own tooth enamel and resistant to stain.

Porcelain veneers are usually done from start to finish in two office visits after an initial visit to analyze how your dream smile will be accomplished, and initial impressions may be taken for planning.  Sometimes we prepare a mockup of the smile changes on a dental model, and sometimes we can use photographs and show you a simulated photo of how your smile will look after you have veneers, but before you go for it.

There are varying factors that determine how much, if any, tooth structure will be removed to produce a healthy and beautiful result.  It’s important to understand how much tooth structure will be removed.  If tooth structure is removed, that is not reversible.  This factor is important because your veneers will last for many years (10-15 years is the statistical average, although we have patients who have veneers for longer than that), however, the younger you are, you should be aware that down the road you may want to replace them due to slight color changes.  If you want the option to not have to replace them, you would want to know if it’s possible to get the result you want without removing any tooth structure.  If no tooth structure is removed, the procedure is reversible.  It usually is advisable to remove some tooth structure especially at the gum line, to encourage optimum gum health, and to have the most natural looking result.

Porcelain veneers feel very smooth and feel just like your own teeth.  They require no additional care other than your routine brushing and flossing.  It’s advisable not to eat ice or bite into bones with your veneers.  Interestingly enough, the strength of the porcelain over the front of your teeth actually strengthens your teeth.

The process is simple, the results are life changing.  If you’ve been unhappy with your smile, what are you waiting for?

For information about other dental topics visit www.TavorminaDentistry.com or call us for a complimentary cosmetic evaluation at 973-761-5090.

Get Rid of Crooked Teeth Once and For All

Do you dislike your smile because of crooked teeth?  Have you put up with feeling self-conscious when you smile or do you hold yourself back from smiling?  Do you cover your mouth when you smile?  Won’t you let now be the time you say, “I deserve a beautiful smile!?” 

There are several ways you may go about getting the straight teeth you desire.  Many people are stopped because as adults they don’t want to be caught dead wearing orthodontic wires or brackets on their teeth.  Wearing conventional braces like these can be psychologically uncomfortable for many people, but there are other avenues.

There are various types of invisible braces available that can handle most cases of crooked teeth.  An evaluation is performed and can determine if you are a candidate for invisible braces.  We use ClearCorrect invisible braces at Tavormina Dentistry because there is more flexibility using this system.  The flexibility of when to receive the next set of tooth repositioners enables us to take into consideration each patient’s compliance with the system, and make adjustments to the patient’s program on an individual basis when compliance is somewhat of an issue.

Very thin clear appliances are worn over your teeth and these can barely be seen, without focused scrutiny.  Every few weeks a new set is received, and your teeth are moved gradually, without the embarrassment of wearing conventional braces.  If for some reason you are not a candidate for invisible braces, you can opt for conventional orthodontic tooth movement.

Another approach involves the use of cosmetic dentistry to change the appearance of your teeth by resurfacing them with dental veneers.  The most beautiful, natural looking, and long lasting veneers are porcelain veneers.  Dental veneers can change the color, size, shape, and apparent position of the teeth.  Hand sculpted bonding is often less of a financial investment, but the hand sculpted bonded materials stain and wear.  Porcelain veneers actually strengthen the teeth and provide a tooth surface that’s even smoother than enamel.

Let’s explore more information about porcelain veneers in our next post.  In the meantime, please visit DrTav.com for other dental information, or call us at 973-761-5090.  We’ll be happy to answer your questions or schedule a free consultation for you.

Have A Smile You Can Be Proud Of

Do you feel uncomfortable when you smile?  Do you hold back smiling?  Some people actually cover their mouth when they laugh or smile.  Why?  Because they wish they had a beautiful smile, and they are ashamed of smiling in front of others.  Do you have any idea how that makes these people feel, or how it limits their lives?  Cosmetic dentistry has solutions for people to smile with pride.

How can modern cosmetic dentistry help beautify a smile?
 

Bonding
Whitening

Veneers

Crowns/Bridges
Invisible braces           
Conventional braces
Crown lengthening
Snapon Smiles
Laser treatment for gummy smiles
Dental implants

That’s quite a list.  These various services address all the various cosmetic challenges someone can face when they smile.  What do you dislike about your smile?

Spaces between teeth
Crooked teeth
Old discolored fillings
Teeth too long or short
Gummy smile
Yellow or dark teeth
Missing teeth

You have so many ways available to you to make a change and get the smile you want and deserve to be proud of.  We do a smile analysis and help you pinpoint the areas of your smile that make you unhappy.  Sometimes when we provide the analysis, the questions we ask help to clarify what the issues all actually are.  Then we discuss the various options and look together with our patient to see what procedure or combination of procedures will bring about the best result.  We factor in the desired result and the budget.  We find that most people do not want to compromise on the result once they know what they want and how to get it.

If you are happy with the shape and size of your teeth, but wish they were whiter, you’d be amazed at what a difference whitening can make.  If your smile is basically attractive, whitening can be just the thing to make your smile pop and give you the confidence you are looking for.

Bonding is when we hand sculpt tooth colored material onto the front surface of a tooth to change its size, shape, color and fill in gaps between teeth.  The filling material fits into small openings in the enamel that are made with dilute acids that take away some of the mineral in the enamel.  These openings enable the bonded material to lock into the enamel.

There’s a lot to learn about these cosmetic techniques.  We will continue our discussion in upcoming blog posts.

For more information about this topic visit www.TavorminaDentistry.com or give us a call at 973-761-5090.

How To Replace Missing Teeth And Enjoy Eating Again!

Did you know that dental implants can offer missing tooth replacement that looks very natural and feels remarkably secure?

Whether you have full or partial dentures or are just missing teeth and have no replacement teeth, dental implants may be an option for you.  As a means of attaching natural-looking teeth directly to the jaw, dental implants can replace one or more teeth, provide support for a bridge, or be used to attach a full denture for either retention or support.

At this time, there are two types of dental implants that are considered safe and effective by the American Dental Association.  These are endosteal and subperiosteal dental implants.

To determine which type of dental implant to use, our practice first looks at the patient's jawbone.  The jawbone must be able to support the dental implants, and both the quantity and the quality of bone must be taken into consideration.            

Endosteal implants act like a metal "root" and are implanted directly into the jawbone.  When the jawbone is thick, a cylindrical endosteal implant is used.  When the jawbone is thin, a slender, plate-type dental implant is recommended.

Unlike an endosteal implant, subperiosteal implantation does not go directly into the jawbone.  Instead, a metal framework is inserted onto the jawbone and under the gum tissue.  This approach is used when the jawbone has an inadequate amount of bone available for endosteal implantation.

Patients who are candidates for subperiosteal implants usually have been lacking some or all of their teeth for several years and there is not enough bone to support their denture.  When there is so little bone remaining to support a denture, it is especially true with lower dentures, that the denture wearer experiences pain and has difficulty to the extent that many of such denture wearers are dental cripples.

The jawbone itself can also be changed or augmented to create a foundation for the dental implant or implants needed by the patient.  To a great extent, the choice of removable or non-removable replacement teeth by the patient will dictate the kind of dental implants used; and the type of dental implant, in turn, is usually the determining factor regarding whether or not augmentation of the jawbone is necessary.

A thorough dental evaluation including a clinical examination of your teeth, radiography (x-rays) and a complete medical history is required to determine if you would be a good candidate for dental implants.

For more information and information on other dental topics visit DrTav.com or call us at 973-761-5090.

Does My Root Canal Therapy Tooth Need A Crown?

A tooth may need a root canal therapy for many reasons.  For those of you who have heard of the term, but don't know what root canal therapy is, we would like to offer some background information.

Inside the hard tissue of each tooth lives the source of vitality for each tooth.  There is space called a chamber inside the hard structures of a tooth, and that chamber houses the blood supply and nerve supply of the tooth.  Sometimes the nerve of the tooth becomes infected and ultimately dies.  When this happens, the blood and nerve supply and any infection in the tooth must be removed and cleaned out.  The chamber extends via narrow canals down the tooth and into the roots of the teeth.  When root canal therapy is needed, the chamber and the canals in the roots are cleaned, disinfected, and shaped so that an inert material can be placed in the canals to seal the tooth and allow any infection that may have spread into the dental bone to heal.  This procedure is called a root canal therapy.  It only treats the nerve and any remaining blood supply to the tooth.  Once decay or infection has entered the chamber, a root canal therapy is the only way to treat this problem, other than extracting the tooth.

Sometimes there are no symptoms at all, and the infection is seen on an x-ray as a dark area at the tip of the root.  Other times, there’s a toothache to deal with – there can be spontaneous pain, and pain to hot and cold and chewing.  Of course we want to save the tooth, so we do a root canal therapy.  But then what do we have to do for the tooth?  Depending on the cause of the root canal, sometimes there is enough tooth structure remaining so that only a small filling is needed to close the opening where the doctor entered into the chamber to perform the root canal procedure.  However, sometimes the tooth has died because of trauma that has fractured or broken tooth structure, or most times, the tooth has had extensive decay that entered the tooth nerve chamber and also destroyed a significant amount of the tooth.  When enough tooth structure has been destroyed by decay or trauma, a dental crown is needed to restore the original form and function of the tooth.

It’s also important to note that sometimes so much tooth structure has been lost, that the dentist has to create a substructure onto which a crown can be cemented.  This is called a post and core.  The post goes into the root canal as a support for a core onto which a crown is fitted and cemented.  When significant tooth structure has been lost, these restorative procedures are needed. 

Teeth that have had root canal therapy obviously can be functional, however, they are dead.  Because they are dead, they tend to be more brittle and susceptible to fracturing.  This is another reason to crown a tooth after having root canal therapy – to protect it from fracture.  It is a shame when someone has saved a tooth with a root canal therapy only to lose the tooth in the future because they didn’t have the tooth protected with a crown.  If a tooth fractures vertically, it cannot be saved and must be extracted.

We hope this information has been useful to you and invite you to visit DrTav.com for more dental information, or call us at 973-761-5090. 

How Your Children Can Have Halloween Candy And You Control It, Too!

It’s that time of the year, again, Halloween.  It’s up there with Christmas as a favorite holiday for our children.  It’s also a time of concern for parents.  We are concerned for their safety when they go out trick-or-treating, we’re concerned about the safety of the treats our children receive, we're concerned about their dental health, and we are concerned that even if everything looks properly wrapped, now what on earth do we do with all this candy?!

There are some strategies that you can use to ensure that your children don’t overdo it with candy this Halloween.  For younger children the strategy of limiting the size of the container that holds their stash is easy for you to pull off.  Purchase a moderate size bag or plastic pumpkin with a handle and tell the children that when the bag/pumpkin is all filled up, trick-or-treat time is over.  This strategy just addresses limiting the amount of candy that comes into the house.

Another strategy for getting candy that limits what’s received is to have a Halloween party, instead of going out trick-or-treating.  The children are certainly safer this way, and having a goody bag with some candy is a treat, but not as overwhelming as a trick-or-treating booty.

Trick-or-treating at a mall can also limit the amount of candy that makes it back home.  It’s amazing how quickly retail stores run out of Halloween candy for the children.

If your children have accumulated a lot of candy there are strategies to deal with this situation.  We register Tavormina Dentistry with the Halloween Candy Buyback.  We buy back the children’s candy and reward them with a hygiene kit goody bag filled with a fun toy, too.  You can visit www.HalloweenCandyBuyback.com to find a participating dental office near you.  Different offices offer different buyback rewards to the children.  The candy is then sent to our troops overseas.  It’s a great way to help the dental health of our children while brightening the day and bringing a little bit of home to our American heroes.  We are buying back candy November 4^th – November 6^th from Noon – 4PM at Tavormina Dentistry 96 Millburn Avenue, Suite 100, Millburn, NJ 07041.

You can also check with your local police station and see if they are participating in a candy buyback program of any kind.

What do you do if you have a lot of candy left in the house?  Have the children choose thirty pieces of candy and tell them to donate anything over thirty.  They can have one piece of candy every day for a month.  The best time to have it is after dinner so that there is only one acid attack from the eating of sugar, instead of dinner and another time later to have candy.  Every time we eat something with sugar in it, there is an acid attack produced by the bacteria that eat the sugar and this attack lasts 20 minutes after eating the sugar.

Well, we’ve given you a lot to chew on to prepare for Halloween.  Have a safe and fun time!

For information about other dental topics please visit us at DrTav.com or call us at 973-761-5090.

Apicoectomy vs. Root Canal Therapy Redo

In this world nothing seems to work 100% of the time.  Unfortunately, although there is a 97% success rate for root canal therapy treated teeth, that does leave some issues to deal with in 3% of the cases.  Sometimes it can be years after the root canal therapy (also known as endodontic therapy) has been performed, and there will be symptoms of discomfort associated with the root canal therapy tooth, or an indication of infection is observed in an x-ray.  What should be done about this?

There are two directions your dentist can take.  One is to perform a surgical procedure called an apicoectomy.  What is an apicoectomy?  It is a surgical procedure that involves making a small incision in the gum tissue above the tooth in the area where the tip of the tooth root is.  Usually when this incision is made and the dentist takes a look under the gums where the incision was made, the dentist will see an area in the bone filled with soft tissue, instead of bone.  We don’t know why in some cases the anticipated healing and filling in of the bone at the tip of the tooth root does not take place after a root canal therapy (and in its place is soft tissue that has to be cleaned out).  However, when this happens, the soft tissue must be removed so that the bone can heal and fill in.  Sometimes the tip of the root is drilled away a little, and a dental filling may also be placed at the remaining root tip.  The success rate for healing the infection with an apicoectomy is approximately 90%.  There isn’t discomfort associated with having an apicoectomy, but there usually is a lot of swelling that occurs.  It’s an opportunity to get some sympathy because it looks like you need it, but you’re not in pain.

The other way to treat the infection is to repeat the root canal therapy procedure.  The success rate of redoing the root canal therapy is 75%.  In addition to having a lower success rate than the apicoectomy, it can be more difficult to redo a root canal therapy if there’s a dental crown on the tooth (which is common with teeth that have had root canal therapy).  If you opt for this approach, you need to be aware that the dental crown will need a filling to seal the opening needed to redo the root canal therapy.  If this would be a cosmetic concern, then a dental crown would need to be replaced as well.  For most people this isn’t a concern, because on back teeth, a tooth colored filling would not be particularly noticeable, and on front teeth, the filling wouldn’t be seen at all because the filling would be on the tongue side of the tooth.

Statistically, the apicoectomy is the preferred choice, but sometimes these decisions are more emotional than rational, and people opt for having a non-surgical approach.  We’re glad that there is another alternative for saving a tooth.

For information on other dental topics, please visit us at www.TavorminaDentistry.com, or call us at 973-761-5090.  

Senior Citizens' Dental Health Problems

Advancing age brings changes in your mouth as well as in the rest of your body.  Does that mean good dental health can't  be maintained or that a bright healthy smile must become something you used to have? Absolutely not!

If you are finding that your teeth seem darker and it's getting harder to keep them looking bright, it may be because aging causes changes in the dentin of your teeth.  The dentin is the bone-like tissue below the enamel of your teeth (the outside layer of the tooth).  The changes in the dentin and the thinning of the enamel give your teeth a darker appearance.  Also, plaque builds up faster and in greater quantities with age.  There are modern procedures proven to brighten your smile.  Bonding, bleaching (take-home and in-office whitening), veneers, all porcelain crowns, and special porcelain fused to yellow gold crowns are available that produce beautiful smile whitening results.

Does your mouth feel dry?  It's not uncommon for older adults to experience a reduced flow of saliva as a result of various disorders or medications.  You need saliva to lubricate your mouth and to wash away food particles and acids produced by that colorless layer of bacteria called plaque, or extensive cavities may develop.  There are products that can restore moisture to your mouth.

Many older adults experience tooth root decay because receding gumlines expose the root surfaces to plaque and decay-causing acid.  Decay around the edges of fillings, which causes decay to weaken fillings and teeth, is also common among senior adults.

For those people who are unable to function with or tolerate their denture or partials there are dental imlants and bone enhancement procedures which replace the missing tooth roots and serve as anchors for teeth. Dental implants are the closest to natural teeth possible.

With your daily effort, an awareness of the changes that occur, and regular professional care, you'll be able to be proud of your smile for many years to come.

For other dental information visit us at www.DrTav.com or call us at 973-761-5090.  We welcome caregiver consultations.

Non-Surgical Treatment Of Gum Disease Saves Lives!

Non-surgical treatment of gum disease therapy is based on the fact that gum disease is an infection.  Some of the bacteria that can be found under the gumline is not infectious and does not lead to bone loss around the teeth.  However, there are other bacteria which when under the gumline, are an infection, and if left untreated, will lead to bone loss, and ultimately tooth loss, if not controlled. 

The use of the phase contrast microscope to study a sample of the contents from beneath a patient’s gums can enable a proper diagnosis and a personalized treatment program based on the severity of any infection observed.  In some cases surgery may be indicated, if the doctor, hygienist, and/or patient cannot reach the infected areas beneath the gumline with the necessary antibacterial agent.  However, the surgery does not treat the infection; it only makes the infection accessible for the non-surgical therapy.  In most cases the patient and the dental team can stop the disease process and stop bone loss.

Non-surgical treatment of gum disease requires each of the four sections of the mouth to have a deep cleaning called scaling and root planning.  A section of the mouth is made numb with anesthesia, and dental instruments which clean the root surface and remove the diseased lining of the gums are used to disrupt the infection and to provide healthy root surfaces to help the gums heal.  An antibacterial liquid is placed below the gums with a water-pik like instrument called an irrigator.  In some cases antibiotic string is placed in the space between the gum and the tooth where the bone used to be.  Samples from under the gums can be taken to view with the phase contrast microscope to evaluate the reduction of infectious bacteria.

If you have gum disease, more can be at stake than your teeth.  As we have been discussing in detail over the past few blog posts, independent studies have shown that there is a correlation between the presence of gum disease and the risk of heart disease.  The latest research guidelines for both the prevention and treatment of gum disease shows the optimum interval between hygiene visits is three months.  Visiting the dentist every three months can help prevent heart disease, and could save your life!  When you consider that 75% of the population has gum disease, most likely this information is of importance to you or someone you love.

For information about gum disease and other dental topics visit www.TavorminaDentistry.com or call us at 973-761-5090.

What Are The Risk Factors Associated With Gum Disease?

The main cause of periodontal (gum) disease is plaque, but other factors affect your gum health.

Studies indicate that older people have the highest rates of gum disease.  Data from the Centers for Disease Control and Prevention indicates that over 70% of Americans 65 and older have periodontitis.

Tobacco use is linked with many serious illnesses such as cancer, lung disease, and heart disease, as well as numerous other health problems.  Tobacco users also are at increased risk for gum disease.  Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of gum disease.

Research has indicated that some people may be genetically susceptible to gum disease.  Despite aggressive oral care habits, these people may be more likely to develop gum disease.  Identifying these people with a genetic test before they even show signs of gum disease and getting them into early treatment may help them keep their teeth for a lifetime.

Stress is linked to many serious conditions such as high blood pressure, cancer, and numerous other health problems.  Stress also is a risk factor for gum disease.  Research shows that stress can make it more difficult for the body to fight off infection, including gum disease.

Some drugs, such as oral birth control, anti-depressants, and certain heart medicines, can affect your oral health.  Remember to always notify your dentist of the medicines you are taking and of any changes in your medications and/or general health.

Clenching or grinding your teeth can put excess force on the supporting tissues of your teeth and could speed up the speed at which the bone supporting your teeth can be destroyed.

Other systemic diseases that interfere with the body’s inflammatory system may worsen the condition of the gums.  These include cardiovascular disease, diabetes, and rheumatoid arthritis.  Interestingly, conversely, having gum disease makes you more susceptible to having these diseases.

Poor nutrition and obesity have shown to be risk factors associated with gum disease.  A diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection.  Because gum disease begins as an infection, poor nutrition can worsen the condition of the gums.  In addition, research has shown that obesity may increase the risk of gum disease. 

Visit us on www.TavorminaDentistry.com for other dental and health information.

Types of Systemic Diseases That are Associated With Oral Infection

In our last two blog posts we have discussed the relationship between gum disease and coronary artery disease and diabetes.  We are continuing the discussion of the oral-body link by introducing the results of research that has found a connection of gum (periodontal) disease and other systemic illness.

Stroke is a disease affecting the blood vessels that supply blood to the brain.  A stroke happens when a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged.  Gums that have periodontal disease release inflammatory chemicals and bacteria into the bloodstream.  This release can result in clogging of the arteries, affect blood platelets, and contribute to the onset of a stroke. Research studies have shown that poor oral health, assessed by dental index, was more common in patients with cerebral infarction (an area of the brain with restricted blood supply).

Infective endocarditis is a bacterial infection of the heart valves or the heart lining.  It occurs when bacteria in the bloodstream lodge on abnormal heart valves or damaged heart tissue.  Endocarditis rarely occurs in people with normal hearts, but people who have certain preexisting heart defects are at risk for developing endocarditis when there’s a bacterial infection circulating in the bloodstream.  Infective endocarditis is a serious and often fatal systemic disease that has been associated with dental diseases and some treatment of periodontal disease. 

Pregnancy can influence gum health and gum health can influence pregnancy.  Changes in hormone levels during pregnancy promote an inflammation called pregnancy gingivitis.  This type of gingivitis may happen without changes in plaque (bacteria levels).  Oral contraceptives can also produce changes in gum health.

Gum disease is a gram-negative infection and may have the potential to affect the outcome of pregnancy.  During pregnancy the ratio of these anaerobic bacteria versus aerobic bacteria increases in dental plaque in the second trimester and the effect has been in some cases, low birth weight babies.

The research continues to uncover more links between oral disease and our overall health.  Studies are also implicating a connection with Alzheimer’s disease, as well.

For information about other dental topics and to get your free copy of our brochure, “The Mouth-Body Link,” visit www.DrTav.com

Diabetes And Gum Disease

Did you know that people with diabetes are more likely to have gum disease than people without diabetes?  This is probably because a person with diabetes is more susceptible to contracting infections.  Periodontal disease is a chronic infection of the gums.  In fact, gum disease is often considered a complication of diabetes.  Uncontrolled diabetics are especially at risk.  When someone has uncontrolled diabetes, they usually have periodontal disease in a moderate to severe form.

Research has suggested that the relationship between diabetes and periodontal disease goes both ways – meaning gum disease may make it often difficult for people who have diabetes to control their blood sugar.  We see this all the time, that when someone treats their gum disease and gets it under control, their blood sugar levels stabilize and often we see that less medication for diabetes, or no medication for diabetes is needed any longer.  What an impact on someone’s life!  To think that someone with diabetes who is on medication, can become a diet controlled diabetic, just be controlling their gum disease.

Severe gum disease can increase blood sugar, contributing to increased periods of time when the body has to deal with and process high blood sugar.  This puts diabetics at increased risk for diabetic complications.

People with diabetes need to take extra special care with their brushing and flossing routine at home and need to make sure they have regular dental checkups.  Someone with gum disease requires regular dental checkups every three months to exercise maximum control of their periodontal disease and the related diabetes. Dental hygiene visits every 12 weeks ensures that the maturation of the bacteria in the plaque that are responsible for the gum disease, is interrupted.  A professional cleaning at this interval disrupts the progression of gum disease.

For information about the connection between our oral health and systemic health, visit www.DrTav.com, where you can download a copy of our free brochure, “The Mouth-Body Link.”

Connection Between Periodontal Disease and Coronary Artery Disease

For some reason we have been programmed to think of our mouth as isolated from the rest of our body.  People who may otherwise be health conscious, might not necessarily place the same priority of care on their dental health, and that’s a mistake.  The mouth is obviously part of the body, and the disease that exists in the mouth is affecting the rest of our body, and the disease that is present elsewhere in our body may be reflected in the mouth.

The original research on the oral-systemic health connection related to the connection of gum disease to heart disease.  Some researchers have suggested that gum disease may contribute to heart disease because bacteria from infected gums can dislodge, enter the bloodstream, attach to blood vessels, and increase clot formation.  It has also been suggested that inflammation caused by gum disease may also trigger clot formation.  Clots decrease blood flow to the heart, thereby causing an elevation in blood pressure and increasing the risk of a heart attack.

According to the American Academy of Periodontology, people with periodontal disease (gum disease) are almost twice as likely to have coronary artery disease (heart disease).  One study found that the presence of common mouth problems such as tooth decay, gum disease, and missing teeth, were as good at predicting heart disease as cholesterol levels.

When patients present with gum disease and have blood tests performed to determine the degree of inflammation present in the system, those readings are high.  However, after the gum disease is treated and is under control, the inflammation markers shown in blood tests is greatly reduced.  When patients are being treated for heart disease and blood tests reveal high levels of inflammation, there is a decrease in these levels after successful treatment of gum disease.

This information, and more on this subject, present a wakeup call to the people in our population who are victims of the false belief that dental and overall health aren’t connected.  We hope it sheds light on the importance of regular dental checkups which include evaluations for periodontal disease, and the subsequent treatment of it.  If you have not seen a dentist in a few years we recommend that you schedule a check up with your Short Hills NJ family dentist to get your teeth cleaned and to make sure that everything is in order.

We have been committed to sharing this information when it first appeared quite a few years ago in 2005.

Restoring Dental Function

At Tavormina Dentistry we do the most basic general dentistry to the most advanced reconstructive dentistry available.  It’s an interesting thing, but when patients come to us because they can’t function, we restore them to full function, of course, but, they also receive the benefit of having the beauty of a brand new functional smile.

We find that so many people are in a position where they literally are dental cripples.  What’s a dental cripple?  Someone who cannot chew their food properly, someone who can’t eat the foods that they enjoy, someone who can only eat basically baby food, someone who suffers with constant pain because of ill-fitting dentures or partial dentures, or someone who suffers from pain from decayed and infected teeth that need extraction or root canal therapy.  There also are social ramifications to all the functional problems.  Too many people can’t smile with freedom because they are too embarrassed to show their teeth, or they don’t have any teeth at all.  There are people who can’t or won’t socialize or eat out in a restaurant, because they can’t chew their food or are afraid their teeth will move or fall out.

We are so thankful that we can make a difference in these peoples’ lives by restoring their dental function and beauty at the same time.  When people find themselves with limited function and they are ready to do something about it, we have a full arsenal of dental procedures to come to their rescue.  We are comprehensively trained in all aspects of dental implants, which are designed to replace missing tooth roots and act as the foundation for an entire new functional dental life.  Depending on the age of the patient and the amount of remaining bone, regular dental implants or mini dental implants can be used as a solution to missing teeth.  Of course, there is always conventional crown and bridgework available, when that’s the best way to restore function.  We do provide removable dentures and partial dentures when necessary, but always aim for restoring our patients to function as closely to how Mother nature intended, and to be able to smile freely and with confidence.

To find out more about how Tavormina Dentistry restores and protects our patients dental function and beauty, please visit DrTav.com, or call 973-761-5090 to personally start experiencing the love and commitment to relationship that drives the care of our patients – our dental family.

Tips For Denture Wearers

Just because you wear dentures doesn’t mean you don’t have to pay attention to your oral health.  Many of the patients at Tavomina Dentistry have come to us and become a part of our dental family because they were unhappy or couldn’t function with their dentures.  Many of these people have been helped and had the quality of their lives transformed miraculously with dental implants, some of them were able to be comfortable with a combination of an upper denture and dental implants on the lower jaw (dentures secured to the implants or crowns placed on the implants), and some just needed new dentures to be made that truly custom fit to their mouths.

Hopefully, if you have a denture, you truly have a custom made denture that took at least five visits to the dentist and time between visits to give the dental laboratory technician the time to customize your denture to your satisfaction.  Even if you did have a well made denture with the best dental practices, having a denture means you don’t have teeth, and when you don’t have teeth, there’s no reason for the dental bone to stay.  Nature does its job by dissolving the dental bone when no teeth are present (this process is called resorption).

Resorption is the main reason that you have to periodically make a new denture.  The tissues in the mouth change over time because of this bone loss, and the bone and gum ridges shrink.  This results in ill-fitting dentures that make eating difficult and even painful at times.  The American Dental Association recommends replacing your dentures every 5 to 7 years, but unfortunately, many people hold on to their dentures much longer.

If you notice that you are using a lot of denture adhesive, it might be time for a denture replacement.  If you use more than one tube of denture paste every three weeks, your dentures may not fit properly and should be evaluated for replacement or relining or rebasing.  Relining replaces the denture material that directly touches the gums and rebasing keeps the present teeth and replaces all of the pink denture material.  Usually denture teeth are worn as well and it’s best to get a new denture.

It’s very important to clean your gums to avoid plaque building up under your dentures, and clean your dentures at night to avoid bacteria growth.  Have a dental checkup at least once a year to check the fit of your dentures to make sure the fit of your dentures isn’t accelerating the bone loss process and to have a cancer screening.  A person is dying every hour of mouth cancer.

For information about other dental topics and denture alternatives visit www.TavorminaDentistry.com or call us at 973-761-5090.

What are All-On-Four Dental Implants?

The technique of All-On Four has taken the dental implant world by storm, but as with any storm, there are dangers.  This technique was originally created to provide a fixed solution to loose fitting or non-functioning dentures for patients who could not afford, or were unwilling to invest time and money for the bone grafting procedures that were required before placing dental implants.

The technique is intended to provide implant supported dentures for people with severe bone loss in the back of the jaw.  This technique is a reaction to the public’s demand for instant gratification, and the desire to spend less and get immediate results.  It represents a departure from established, predictable procedures and compromises the well being of the patients it is supposed to be serving.

When there is insufficient bone to place the necessary implants to support a denture, bone grafting is always recommended.  All-On-Four technique ignores over 25 years of research that indicates the necessity to wait 3 – 6 months for the dental implants to become part of the jaw (this process is called osseointegration) before placing force on the dental implants.  The osseointegration of dental implants is compromised and likely to fail if the dental implants have regular chewing function before the waiting period is complete.

In this technique, four dental implants are placed in the front of the mouth where there usually is more bone.  The back implants are placed at a 30 degree angle, tipping the implants over.  This violates the engineering principle that dental implants function effectively and are stable when forces placed on them are vertical.  With the All-On-Four dental implant technique, the forces are unfavorable for implant survival.  If one of the implants fail in this technique, the entire restoration fails and has to be reconstructed.  Sometimes the loss of bone is so extensive that the patient cannot even wear a denture after this procedure.

Implants are placed only in the front jaw, therefore the jawbone deterioration continues at the back of the jaw, increasing the risk of what is called a facial collapse.  If the jaw becomes too weak, the jaw may fracture due to pressure applied to the front of the mouth when eating.

At Tavormina Dentistry we are all for saving our patients time and money, but not at the expense of their health and happiness.  There are alternatives that might not necessarily cost more than All-On-Four, but which can take more time.

Do Your Teeth Come From China?

For several years there has been a problem of some dentists using dental laboratories in India and China.  Why is this a problem?  Because overseas labs are not subject to meeting the requirements established by the American Dental Association.  What does this mean to American patients?  Dangerous levels of lead have been found in crowns, veneers, and dentures coming from China.  Although no one can be exactly sure of the health risks this presents, we all know that lead can be dangerous to our overall health and nervous system.

At Tavormina Dentistry we pride ourselves on using only local and American labs who are quality driven and who do not outsource their work overseas.  This is a choice we make to provide the best care to our patients and to be able to sleep at night.

Dentistry is not an inexpensive healthcare service, but at least let’s have there be integrity in the field and a good reason for the costs involved.  We do pay higher dental lab fees and reduce our profits to be sure that our patients are protected from the practice of outsourcing or directly working with Chinese and Indian dental labs.  Our dental lab costs are 7 – 8 times higher than that of a dentist who jeopardizes their patients’ safety to make a greater profit.

Substandard quality has been documented from some of the overseas labs, too.  Poor fitting crowns can lead to tooth decay under the crowns and eventual root canal therapy or tooth loss.  Some of the overseas work doesn’t look like teeth and the color matching is not up to the standard of good domestic laboratories.  Imports are not checked or required to reach ADA specifications. 

There are choices that dentists make, even if they are using domestic laboratories, that can keep their costs down and profits up.  For example, at Tavormna Dentistry we use precious metals for our crowns instead of nonprecious metals that tend to corrode in the mouth.  Precious metals such as gold and palladium are more expensive for us to use for our patients’ dentistry, but they are what’s best for our patients, so we choose them.  These metals may look the same, but they don’t deliver the same results.

We all want to be cost conscious, but dental care and healthcare are not the place to look for the lowest fee.  You most likely are not getting the same product as the patient who is paying more.  Protect yourself and make sure your dentist is using precious metal and using domestic dental laboratories that don’t outsourse their work overseas.

For information about other dental topics visit DrTav.com

Dentistry Is More Specialized Than You May Think!

Most people are aware that there are various dental specialties.  We know there are general dentists, and if you’re very fortunate, your general dentist has invested significant time and money in furthering his/her dental education beyond dental school, as we do at Tavormina Dentistry.  Dentistry is constantly improving with advances in patient comfort, dental procedures, dental materials, and dental equipment.

But did you ever stop to think about the various areas of specialization that are required for producing actual dental crowns, bridges, and dentures?  Dentists are responsible for providing accurate impressions of your mouth so that a dental laboratory technician can fabricate that new tooth or teeth for you.

In a dental laboratory there are several areas of specialization that are responsible for the beautiful end result your dentist is responsible for.  There are technicians that are responsible for the fabrication of dental models and the proper use of dental models in the process of making dental prostheses.  There are dental model technicians and also model technicians that have to expertly segment a model (making what are called dyes), so that each tooth that needs to be worked on can be handled individually.  Then all the dyes have to be put back like a puzzle and fit exactly so that the person’s new dentistry will fit perfectly in the mouth and restore tooth structure and function accurately.

Dental waxers are the technicians who form the metal substructures of crowns and bridges, in wax.  Ultimately, the wax is replaced by being cast with dental metals.  There are lab technicians that specialize in the proper finishing of the metal.  Each step of the process is provided by people who are expert in one small aspect of the final restoration.

There are dental laboratory technicians who areceramists.  The ceramists slowly build a smile with porcelain and provide the artistry that is responsible for the subtle nuances that make the finished crowns and bridges look beautiful and natural.

Some dental laboratory technicians are trained to focus on the art and science of making crowns and bridges, while other dental technicians focus on setting up denture teeth for dentures and focusing on making dentures and partial dentures look as natural as possible and return the patient’s function.

All the steps are very detailed, as are the steps the dentist has to take to make sure the laboratory has what it needs to satisfy the patient’s needs.  The final step is the dentist verifying the accuracy of the final result.  There’s a lot of teamwork that goes into providing dental services to our dental family.

For information on other dental topics visit www.TavorminaDentistry.com, or of course,

feel free to call us at 973-761-5090.  We welcome the opportunity to help you.

Are You Afraid To Go To The Dentist?

This past week Tavormina Dentistry has posted several articles on social media sites about dental fear and dental phobias.  So, we thought this would be a good opportunity to talk about this topic a bit on our blog.

It’s sometimes difficult to determine where the fear starts.  Sometimes there aren’t any bad experiences specifically to point to, and of course, unfortunately, sometimes there are.  When there is no apparent reason for the fear of going to the dentist, the fear may be related to feeling out of control sitting in the dentist’s chair and having to stay still and have the dentist work inside your mouth.  It can feel frightening for some people to have their space feel violated.  It’s important in such cases to have an understanding dentist with whom you have developed a signal for the dentist to stop working.  This is an easy way to regain control of the situation and develop trust.

From a treatment standpoint, dentistry has become easier than ever to provide with a pain free experience.  A combination of anesthesia, to put the area being worked on to sleep, combined, in some cases, with various means of sedation for the patient, to help the patient sleep too, can work wonders.

Our approach at Tavormina Dentistry is to be a partner with our patient to determine what they need for a comfortable experience.  We start conservatively with an option of teaching our patients relaxation techniques.  These techniques, for the patient who is willing, can teach the patient that they are in control of their experience.  People don’t realize how powerful their minds are in determining what their experience is. 

For patients who do not want to learn relaxation techniques, but who want to feel very relaxed while having their dentistry, we have laughing gas, also called nitrous oxide.  This is a very safe alternative that let’s someone feel very happy while having dentistry, and also enables the patient to be able to drive themselves home.

For patients who want to fall asleep or be very sleepy during their dental visit, there is oral conscious sedation.  Oral medication is given and it is very effective in having most people fall asleep during their dentistry and also have no memory of the dental procedures.

For those patients who are afraid that they will not fall asleep, there is intravenous conscious sedation.  We have a board certified anesthesiologist administer the IV sedation and monitor our patients who want the assurance that the depth of their sedation can be controlled and deepened as needed.

As you can see, with patience and understanding you can find a partnership with a dentist so that you no longer have to be afraid of going to the dentist, or at least won’t let the fear

stop you.

For more details visit DrTav.com or call us at 973-761-5090.  We'd love to help.

Do You Have Pain From Clenching Your Teeth?

If you have pain from clenching your teeth, you know how difficult it seems to be to have relief.  In the past, bite guards that covered all of your teeth had to be used and they were often considered cumbersome and caused gagging.  At Tavormina Dentistry we have been pleased to help people with clenching, bruxing, and migraine pain.

We’re fortunate to have over the past decade another alternative that works very well.  The NTI-tss Plus appliance was originally developed to prevent migraine pain.  It is a useful appliance for migraine headaches, but like the inventor of post-it notes discovered, an invention can have other uses that may even be unanticipated.  Even though the NTI-tss Plus works for migraine pain, it was discovered that this appliance eliminates tooth wear from bruxing and clenching and muscle pain associated with muscle dysfunction.  As dentists we can have a way to simply and effectively treat patients who suffer from tension and migraine headaches by reducing the intensity of jaw clenching while patients sleep.

This appliance does the job of a full-arch bite guard but only covers four of the front teeth either on the top or lower arch.  Full-coverage bite guards can increase clenching for some patients, because they create an ideal clenching surface for eye teeth and molars.  The NTI-tss Plus keeps the back teeth from touching and reduces clenching intensity by almost 70%.  Also, because the device is smaller and less bulky than traditional bite guards, patients are more likely to use it.

The NTI-tss Plus is a small, clear shell with a patented special edge that attaches to the front teeth area.  Because the NTI-tss Plus covers only the front teeth, it takes less time to make the appliance and it’s easier to seat in the mouth and requires fewer adjustments compared to a traditional bite guard.  The appliance is more comfortable than traditional bite guards and because it is less bulky, it does not trigger the gag reflex.

The appliance has flexibility and can be used as an appliance for upper or lower teeth.  Factors that influence which arch is used for an appliance include the length of the crown of the tooth, the shape of the tooth, the position of the teeth, uneven edges of teeth, and narrow arch width.  There also is an NTI-tss Plus Soft appliance which is also available when teeth are extremely crowded, slightly mobile, or especially sensitive.

For information about other dental topics visit www.TavorminaDentistry.com

How Does Dental Insurance Work?

The other day a patient was in for a visit and told us she was not going to have dental insurance coverage after December.  She and her spouse had assumed that they would research dental insurance coverage to replace what they presently had.  I offered them the free service that we provide at Tavormina Dentistry of reviewing any research they came up with and evaluating the information for the best coverage, as well as evaluating for any savings by not replacing the dental benefit.

It’s important to remember that dental insurance is not an insurance, but a benefit.  The difference is that for most dental plans, there is a limit to the total amount that the insurance will pay out per year.  The dental benefits vary based on the plan the employer or privately insured person has agreed upon with the insurance company.  Most dental plans don’t reimburse for services more than $1,000 maximum per person per year.  This was a pretty good amount in 1969 when dental “insurance” came into existence, but in 2013, unfortunately, $1,000 coverage doesn’t go very far, especially if the patient with the dental benefit has significant dental needs.

On the other hand, if a patient visits the dentist regularly, and does his own homecare well, they most likely only have the fees for regular routine maintenance.  Very often the fees that a dental office charges for routine prevention, diagnosis, and cleanings can be less than the premiums for, let’s say $1,000 coverage.  So, if you only need routine care, it may make more sense to use your money to cover the routine care, especially if the premium for a limited dental benefit is greater than the fees for these services.

Having a dental benefit is most useful when you do have need for additional dental services in Millburn NJ and when there is an employer in the picture paying the dental insurance premium.  In most cases dental coverage for prevention, diagnosis, and cleanings is covered in full or almost completely by the dental benefit, and should make it very easy for people to receive routine health maintenance visits twice a year, which is the usual limit for such care for most dental insurance plans.  Although most adults ideally benefit most by checkups and cleanings every 3 months (based on scientific research), when people have dental benefits, they usually find they are only covered for two such visits.  Some coverage is better than none.  Don’t let your coverage dictate how frequently you have preventive/hygiene visits.  There are many different kinds of plans, so what is covered, and when, varies.

The best advice we can give is that if you are interested in having dental benefits, make sure you have the freedom to choose to see whatever dentist you want, and still receive your dental benefit.  You want to choose your dentist, not have the insurance company choose your dentist for you.

For information about other dental topics visit www.DrTav.com

What Are Invisible Braces?

Invisible braces are clear, custom aligners that are made to gradually move teeth into an attractive, healthy smile without using wires, bands, or brackets on teeth. Who are invisible braces designed for?

Invisible braces are the answer for adults who don’t want anyone to know that they are having their teeth moved and by some teens who don’t want the distraction of a smile filled with wires and elastics. Not all teens are good candidates for invisible braces because the aligners are removable, therefore making strict compliance of the invisible braces technique a necessity.

Once a dentist or orthodontist in Millburn NJ examines you to determine if you are a candidate for invisible braces, your doctor will take impressions, photos, and sometimes x-rays.

At Tavormina Dentistry we use the ClearCorrect system to move our patients’ teeth with invisible braces. We send a prescription along with your records to ClearCorrect and their laboratory uses 3D technology to create aligners with computer precision. Each aligner moves your teeth a little bit at a time until you eventually get straight teeth.

In the first phase of treatment the aligners are passive. These aligners won’t move your teeth. They are to be worn as practice to get used to wearing your custom, clear aligners. The aligners are to be worn all day except when eating and drinking and during daily oral care such as brushing and flossing.

The sets of aligners are usually worn in 3 week intervals and with each successive set of aligners, your teeth get closer and closer to your desired result. For information about other dental topics visit www.TavorminaDentistry.com

What Does A Dental Laboratory Tech Do?

Dental laboratory technicians are very important members of dental healthcare.  They make the prostheses, the actual replacements, for patients who are missing some or all of their teeth. 

Dental laboratory technicians use impressions, or molds, of a patient’s teeth to create crowns, bridges, dentures, and other dental appliances. They work closely with dentists but have limited contact with patients.  In our office in Millburn we are fortunate to work with several talented and proficient laboratory technicians.  We work with labs across the country when the procedure we are providing is done best by a distant lab, however, we also work with several talented local laboratories and we do have the advantage of local dental laboratory technicians visiting our office, when necessary, to provide the best result for our patients.

Dental laboratory technicians work directly with dentists by following detailed written instructions and using impressions (molds)of the patient's teeth or oral soft tissues to create replacements for missing teeth. 

The dental technician is responsible for accurately following the prescription the dentist sends the dental laboratory so that a patient’s teeth can be restored to proper function, comfort, and aesthetics.  The prostheses they make enable people to eat, chew, talk and smile in a manner that is similar to or better than the way they did before.

Dental technicians work with a variety of materials in replacing damaged or missing tooth structure. These include waxes, plastics, precious and non-precious alloys, stainless steel, and a variety of porcelains and composites or polymer glass combinations.

The best way to become a dental technician is to receive formal education. Studying in a Commission on Dental Accreditation accredited program provides education that is based on the latest procedures and techniques. Dental technicians can begin their careers without a college degree; however, continuing education is encouraged. The best dental laboratory technicians have manual dexterity, and accuracy, artistic ability, and attention to minute detail.  The artistry and attention to detail result in the most beautiful smiles for the dental patient. We are proud of our Millburn office's commitment to providing dental care beyond compare and working with dental laboratory technicians who have the same passion.

For information about other dental topics visit www.TavorminaDentistry.com

Does A Great Smile Equal A Great Job?

Many people may consider the cosmetics of their smile to be unimportant compared to their dental health, and we certainly can understand that way of thinking.  However, the appearance of your smile and the health of your smile are usually quite connected.  Life demonstrates that cosmetics are a lot more important than one may think.

Of course, first and foremost, you want to have healthy teeth and gums.  Proper daily dental hygiene of brushing and flossing is the first line of defense against dental problems.  Next, visiting the dentist regularly, according to a health maintenance schedule that is appropriate to your personal dental health needs is necessary.  Once you are on this right track, take the time to look at the appearance of your smile.   What do people really see when you smile?  How does your smile make people feel?  Do you hold back from smiling?

The answers to these questions are really interesting when considering what a potential employer sees or is reacting to.  We all know, even if we don’t consciously think about it, that there are stereotypic impressions made by different kinds of smiles.  Unfortunately the appearance of your teeth can connote stupidity or low socioeconomic status.  It isn’t nice and it isn’t fair, but it is a harsh reality of this world. Research has shown that when people are offered dental care, it increases their chances of employment.  

The most obvious deterrent to an employer hiring you would be missing teeth that can be seen when you speak or smile.  You can understand that especially if your position would involve contact with the public, such jobs are not going to be possibiities for you.  An employer cannot take a chance that your image will translate over to the image of the company.  Especially positions of service such as reception, cashier, sales, would be off the table for you most likely, if you are missing some or all of your front teeth.

Crowding of teeth and a smile with stains or blackened decay pose additional problems.  Bad breath from gum disease and obviously dirty teeth can be a deterrent to employment as well.

There is a terrible vicious cycle happening in our country where many people find themselves unemployed for extended periods of time.  Once dental problems such as those discussed in this post appear, the cycle of unemployment is difficult to break.

Good daily prevention can help prevent this cycle, but sometimes that is not enough without professional dental care.  Whether you are unemployed or have no dental coverage of any kind, remember that visiting the dentist even once a year is not a big expense (payment plans can usually be arranged – especially if you have had a good working relationship with a dentist before you came on hard times).  Staying away from the dentist when resources are low or depleted actually will cost you more in the long run – more time and more money to restore the damage, as well as dfifficulty getting employment.

For information about other dental topics visit www.TavorminaDentistry.com